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David Saul Rosenfeld, M.D.,Iz and Antoine Jean Elhajar, M.D.1
Sexual acts performed by a sleeping subject have been rarely reported. Two cases are now presented involving sexual behavior performed while asleep. The first case involves the hitherto unreported association of sleepsex with sleepeating. The second case concerns a rarely reported act of sexual battery by a known sleepwalker, and the use of somnambulism as a legal defense. Sexual behavior in sleep may be pleomorphic and more common than realized in both the patient and normal populations. KEY WORDS: sleepsex; sleepeating; sleepwalking.
INTRODUCTION
Sexual activity performed by a sleeping subject has been rarely reported. Two cases are now described, one case involving a patient with a history of a sleep-related eating disorder allied with prominent sexual behavior in sleep, the second concerning a sexual assault performed by a somnambulist while ostensibly asleep.
CASE 1
A 43-year-old male suffered from nightly episodes of eating in his sleep, as well as prominent sexual activity while asleep for approximately the past 20 years. The patient himself was entirely unaware of these events, the complaints being articulated by his girlfriend of the past 2 years, as well as by other sleep partners in the past. His present sleep partner first became alarmed when she realized one night that while having intercourse in their darkened bedroom that the patient was snoring loudly. She then was able to document nightly episodes occurring generally once a night, 7-nights-a-week of the patient initiating sex, the sexual activity lasting as long as 30 min, orgasm and ejaculation achieved, and the patient being entirely amnestic for the events in the morning. It was also their custom to have intercourse upon the final awakening in the morning with the patient in a conscious state.
The repertoire of unconscious sexual activity by the patient was varied and included intercourse in different body positions, as well as oral sex, both given and received. The girlfriend was emphatic in her insistence that the patient's sexual manner and style while asleep were different from his waking behavior, the patient being more aggressive and dominant than was his custom while making love in the awake state. She also remarked that some of the activities exhibited by the patient such as...