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Sexsomnia: What sleep sex is.

Sexsomnia or sleep sex occurs when an individual engages in sexual acts while asleep.

Most available research has found that sexsomnia episodes occur mostly during non-rapid-eye-movement (NREM), the dreamless, deepest stage of the sleep cycle.

Sexual dreams are not considered a type of sexsomnia because they do not involve physical actions or behaviors aside from arousal and ejaculation.

What is sexsomnia?

Man-sleeping-and-snoring-overhead-view

Sexsomnia is when a person enagages in sexual activity while sleeping.

Sexsomnia is considered a type of parasomnia, an abnormal activity, behavior, or experience that occurs during deep sleep. But many of the facts about sexsomnia, such as its exact cause, the variety of symptoms, and its prevalence, are not understood.

Sexsomnia is a relatively new condition, with the first official case reported in 1986. And according to a 2015 study, only 94 cases of sleep sex have been documented worldwide.

Sexsomnia is also very difficult to study long-term because it takes place randomly during the night.

Symptoms

Sexsomnia often causes self-touching or sexual motions, but it can also cause an individual to seek sexual intimacy with others unknowingly. Sexsomnia may also occur at the same time as other parasomnia activities, such as sleepwalking or talking.

Sometimes it is a partner, roommate, or parent, who first notices symptoms of the condition. Sexual partners might also notice that their partner has an abnormally heightened level of sexual aggression and decreased inhibitions randomly in the night.

Common symptoms of sexsomnia episodes include:

  • fondling or rubbing
  • moaning
  • heavy breathing and elevated heart rate
  • sweating
  • masturbating
  • pelvic thrusting
  • initiating foreplay with someone else
  • sexual intercourse
  • spontaneous orgasm
  • no recollection or memory of sexual events
  • blank or glassy stare during events
  • unresponsive to outside environment during events
  • inability or difficulty waking during events
  • denial of activities during the day when fully conscious
  • sleepwalking or talking

Aside from the physical symptoms that occur during episodes, sexsomnia can have harmful emotional, psychosocial, and even criminal consequences.

Triggers

Exhausted and tired doctor, stressed and anxious because of shift work.

Sleep deprivation, stress, and shift-work may all trigger sexsomnia.

As with other parasomnias, such as sleepwalking, it seems sexsomnia is caused by a disruption while the brain is moving between deep sleep cycles. These disturbances are often called confusion arousals (CAs).

Though the causes of sleep sex remain unknown, research shows the condition has clear risk factors, primarily medical conditions, lifestyle habits, jobs, and medications that interfere with sleeping patterns.

Triggers considered to increase the likelihood of sexsomnia include:

  • lack of sleep
  • extreme exhaustion
  • excessive alcohol consumption
  • use of illegal drugs
  • anxiety
  • stress
  • poor sleeping conditions (too light, noisy, or hot)
  • poor sleep hygiene or schedule
  • shift work, especially high-stress jobs, such as military or hospital work
  • travel
  • sharing a bed with someone, regardless of their relationship with the person

Obstructive sleep apnea is linked to many of the documented cases of sexsomnia, likely because it causes disruptions during deep sleep.

Some people who develop sexsomnia in adulthood engage in other parasomnia behaviors, most commonly sleepwalking, or did in childhood.

Medical conditions considered risk factors for sexsomnia include:

  • obstructive sleep apnea (OSA)
  • restless leg syndrome
  • gastroesophageal reflux disease (GERD)
  • irritable bowel syndrome (IBS)
  • a history of other parasomnia activities, such as sleepwalking or talking
  • Crohn’s disease
  • colitis
  • ulcers
  • migraine headaches
  • types of epilepsy and other seizure disorders
  • head trauma
  • medications for anxiety and depression, specifically escitalopram (SSRI)
  • sleep-related dissociative disorder, a condition often related to childhood sexual trauma
  • Parkinson’s disease

Link to drugs, alcohol, and medication

When sexsomnia is related to the use of alcohol or illegal drugs, treatment involves immediately stopping use or reducing the drug to a safe level of use.

People experiencing sleep sex as a side effect of prescription medications may need to stop taking the drugs or change the dosage.

In many cases though, the benefit of the medication outweighs the side effects, so treatment may focus on reducing the impact of sexsomnia symptoms.

Treatment and management

It seems that the best way to treat the condition is to maintain a healthy, regular, sleep-wake schedule.

In most reported cases, symptoms of sexsomnia were reduced or resolved when individuals got more consistent, high-quality sleep.

The actual effect of treatment on sexsomnia is poorly understood because the symptoms are difficult to track long-term.

Sexsomnia medications

Woman taking medication pills with glass of water.

Some medications may be recommended to treat sexsomnia, including mild sedatives and antidepressants.

In some reported cases, off-label medications designed and approved for the treatment of other conditions have been used to manage sexsomnia.

Treating underlying conditions that cause sleep disruption, such as sleep apnea, may also reduce or resolve cases of sexsomnia.

Medical treatment options for sexsomnia include:

Lifestyle changes

In nearly every described case of sexsomnia, at least part of the treatment process involved lifestyle adjustments. As many of the symptoms of sexsomnia negatively impact other people, the best way to treat it tends to be nighttime isolation.

Some people with sexsomnia reduced problematic symptoms by locking themselves in their bedroom alone at night or placing an alarm system on their bedroom door.

Psychological management

Seeing a psychiatrist or psychologist may also reduce feelings of embarrassment and shame associated with sexsomnia.

People with sexsomnia may also significantly reduce emotional and psychosocial symptoms by undergoing group counseling sessions with the person negatively impacted by symptoms.

In most documented cases, sexsomnia symptoms have alarmed or angered the conscious bed partner.

A 2007 study concluded, however, that during sexsomnia episodes some partners were less hurried, gentler, and more focused on satisfying their partner.

Diagnosis

Sexsomnia was only recently classified medically, so there is no standard diagnostic process for the condition.

A psychiatrist, often one specializing in sleep disorders, may diagnose sexsomnia by reviewing individual medical history and asking questions about symptoms. However, the most widely accepted diagnostic method for sexsomnia is video-polysomnography (vPSG).

During vPSG, an individual is attached to physiological devices, such as heart rate, breathing, and motion monitors, and videotaped while they sleep.

Currently sleep sex is classified as a type of parasomnia in the Diagnostic Statistical Manual of Mental Disorders (DSM-5).

The International Classification of Sleep Disorders, Third Edition (ICSD-3), also classifies sexsomnia as a type of non-REM parasomnia.

Complications

Some people feel ashamed or embarrassed to learn they have done things they do not remember doing, especially sexual acts.

Sexsomnia can also make the question of consent difficult, given the individual initiating or engaging in the sexual act is technically unconscious. Several court cases have involved charges of sexual misconduct relating to sleep sex with a variety of outcomes.

Although a person’s medical history and other evidence will be carefully examined in court, determining responsibility remains complicated and controversial.

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Thirst: Our brains tell us when to stop drinking

When the water content of our blood drops, neurons in the brain tell us that we are thirsty. But how do we know when enough is enough?
Water

Water is essential to life. When we get deydrated, it can have serious consequences.

The water content in our body is tightly regulated. Dehydration can lead to dizziness, delirium, and unconsciousness. Drinking fluids restores this balance or homeostasis.

But it takes time for water to travel from our mouths through the body. We stop drinking a long time before this happens.

If we kept drinking during this delay, we would be at serious risk of water intoxication, or water poisoning, which is potentially deadly.

Scientists are beginning to unravel the sophisticated mechanisms that stop us from drinking too much water, and the answer lies in the brain.

What controls thirst?

The brain’s thirst control circuit is a small region in the forebrain called the lamina terminalis (LT).

Once the LT network is activated, we become thirsty. A study published last week in the journal Science demonstrated that thirst creates an uncomfortable feeling in mice, which is alleviated by drinking.

There is one other thing that triggers thirst: eating. As soon as we start to eat, our thirst is stimulated. This is known as prandial thirst.

Water is necessary for us to digest the food that we eat. It also stops electrolytes in food from disturbing homeostasis by balancing out the fluid levels.

Why do we stop drinking?

Zachary A. Knight, Ph.D. – from the Department of Physiology at the University of California, San Francisco – and his team reported in the journal Nature that neurons in the subfornical organ (SFO), which forms part of the LT, might be at the heart of things.

The authors explain that “much normal drinking behavior is anticipatory in nature, meaning that the brain predicts impending changes in fluid balance and adjusts behavior pre-emptively.”

For their study, the researchers used mice and restricted their access to water overnight. “When water was made available,” the authors write, “mice drank avidly and, surprisingly, [SFO] neurons were inhibited within 1 min.”

This drop in neuronal signaling happened much faster than the water was able to reach the blood.

“Drinking resets thirst-promoting SFO neurons in a way that anticipates the future restoration of homeostasis,” they add. This means that our brain anticipates how much water we need to drink to restore homeostasis.

Signals from the mouth to the brain

What is not yet clear is how the brain knows when we are drinking fluids. A recent study published in the journal Nature Neuroscience pointed the finger at receptors in our mouth.

The team – led by Yuki Oka, Ph.D., who is from the Division of Biology and Biological Engineering at the California Institute of Technology in Pasadena – showed that water changes the acid balance in the saliva, which activates acid-taste receptors.

So, what is the best way of quenching thirst? A study by Sanne Boesveldt, Ph.D. – from the Division of Human Nutrition at Wageningen University & Research in the Netherlands – and her team, which will be published in the October edition of the journal Physiology & Behavior, set out to answer this question.

The authors explain that cold drinks are already known to be more thirst quenching, as are sour, flavored, and carbonated drinks.

In their study, the team found that cold, flavored popsicles were significantly more thirst quenching than cold liquids. The most effective flavor was lemon.

So, while the days may be getting colder as fall gets underway in the Northern hemisphere, a lemon popsicle might still be a good option the next time thirst calls.

Can yoga improve your sex life?

he Internet abounds with wellness blogs that recommend yoga for a better sex life, as well as personal accounts of the practice improving sexual experience — often to an enviable degree. Does the research back up these claims, however? We investigate.

woman doing cat cow

Yoga can be a relaxing and enjoyable way to enhance our sex lives.

Modern research is only just starting to unpack the numerous health benefits of the ancient practice of yoga.

Some conditions that yoga reportedly helps with include depression, stress, and anxiety, as well as metabolic syndrome, diabetes, and thyroid problems.

Recent studies have also delved into the more complex mechanisms behind such benefits.

It turns out that yoga lowers the body’s inflammatory response, counters the genetic expression that predisposes people to stress, lowers cortisol, and boosts a protein that helps the brain grow and stay young and healthy.

On top of all its benefits, we must add, it just feels good. Sometimes — if we’re to believe the hype around the mythical coregasm during yoga — it feels really, really good.

Getting in touch with our bodies can feel replenishing, restorative, and physically pleasurable. However, can yoga’s yummy poses improve our sex lives? We take a look at the research.

Yoga improves sexual function in women

One often-referenced study that was published in The Journal of Sexual Medicine found that yoga can indeed improve sexual function — particularly in women over the age of 45.

woman doing triangle pose

The triangle pose was among those shown to improve sexual function — particularly in older women.

The study examined the effects of 12 weeks of yoga on 40 women who self-reported on their sexual function before and after the yoga sessions.

After the 12-week period, the women’s sexual function had significantly improved across all sections of the Female Sexual Function Index: “desire, arousal, lubrication, orgasm, satisfaction, and pain.”

As many as 75 percent of the women reported an improvement in their sex life after yoga training.

As part of the study, all of the women were trained on 22 poses, or yogasanas, which are believed to improve core abdominal muscles, improve digestion, strengthen the pelvic floor, and improve mood.

Some poses included trikonasana (also known as the triangle pose), bhujangasana (the snake), and ardha matsyendra mudra (half spinal twist). The full list of asanas can be accessed here.

Yoga improves sexual function in men

Yoga doesn’t benefit just women. An analogous study led Dr. Vikas Dhikav, who’s a neurologist at the Dr. Ram Manohar Lohia Hospital in New Delhi, India, examined the effects of a 12-week yoga program on the sexual satisfaction of men.

man doing bow pose

The bow pose may improve sexual performance in men.

At the end of the study period, the participants reported a significant improvement in their sexual function, as evaluated by the standard Male Sexual Quotient.

The researchers found improvements across all aspects of male sexual satisfaction: “desire, intercourse satisfaction, performance, confidence, partner synchronization, erection, ejaculatory control, [and] orgasm.”

Also, a comparative trial carried out by the same team of researchers found that yoga is a viable and nonpharmacological alternative to fluoxetine (brand name Prozac) for treating premature ejaculation.

It included 15 yoga poses, ranging from easier ones (such as Kapalbhati, which involves sitting with your back straight in a crossed-legged position, with the chest open, eyes closed, hands on knees, and abdominal muscles contracted) to more complex ones (such as dhanurasana, or the “bow pose”).

Yogic mechanisms for better sex

How does yoga improve one’s sex life, exactly? A review of existing literature led by researchers at the Department of Obstetrics and Gynaecology, from the University of British Columbia (UBC) in Vancouver, Canada, helps us elucidate some of its sex-enhancing mechanisms.

couple doing yoga

Yoga could help partners enjoy better sex.

Dr. Lori Brotto, a professor in the Department of Obstetrics & Gynaecology at UBC, is the first author of the review.

Dr. Brotto and colleagues explain that yoga regulates attention and breathing, lowers anxiety and stress, and regulates parasympathetic nervous activity — that is, it activates the part of the nervous system that tells your body to stop, relax, rest, digest, lower the heart rate, and triggers any other metabolic processes that induce relaxation.

“All of these effects are associated with improvements in sexual response,” write the reviewers, so it is “reasonable that yoga might also be associated with improvements in sexual health.”

There are also psychological mechanisms at play. “Female practitioners of yoga have been found to be less likely to objectify their bodies,” explain Dr. Brotto and her colleagues, “and to be more aware of their physical selves.”

“This tendency, in turn, may be associated with increased sexual responsibility and assertiveness, and perhaps sexual desires.”

The power of the moola bandha

It is safe to say that stories about releasing blocked energy in root chakras and moving “kundalini energy” up and down the spine to the point that it produces ejaculation-free male orgasms lack rigorous scientific evidence.

However, other yogic concepts could make more sense to the skeptics among us. Moola bandha is one such concept.

“Moola bandha is a perineal contraction that stimulates the sensory-motor and the autonomic nervous system in the pelvic region, and therefore enforces parasympathetic activity in the body,” write Dr. Brotto and her colleagues in their review.

“Specifically, moola bandha is thought to directly innervate the gonads and perineal body/cervix.” The video below incorporates the movement into a practice for pelvic floor muscles.

Some studies quoted by the researchers have suggested that practicing moola bandha relieves period pain, childbirth pain, and sexual difficulties in women, as well as treating premature ejaculation and controlling testosterone secretion in men.

Moola bandha is similar to the modern, medically recommended Kegel exercises, which are thought to prevent urinary incontinence and help women (and men) enjoy sex for longer.

In fact, many sex therapy centers recommend this yoga practice to help women become more aware of their sensations of arousal in the genital area, thus improving desire and sexual experience.

“[M]oola bandha stretches the muscles of the pelvic floor, […] balances, stimulates, and rejuvenates the area through techniques that increase awareness and circulation,” explain Dr. Brotto and colleagues, referring to the work of other researchers.

Another yoga pose that strengthens the pelvic floor muscles is bhekasana, or the “frog pose.”

As well as improving the sexual experience, this pose may help ease symptoms of vestibulodynia, or pain in the vestibule of the vagina, as well as vaginismus, which is the involuntary contraction of vaginal muscles that prevents women from enjoying penetrative sex.

How reliable is the evidence?

While it is easy to get, ahem, excited by the potential sexual benefits of yoga, it is worth bearing in mind the large discrepancy between the amount of so-called empirical, or experimental, evidence, and that of non-empirical, or anecdotal, evidence.

frog pose

Bhekasana, or the frog pose, may strengthen pelvic muscles.

The Internet hosts a plethora of the latter, but the studies that have actually trialed the benefits of yoga for sexual function remain scarce.

Additionally, most of the studies mentioned above — which found improvements in sexual satisfaction and function for both men and women — have quite a small sample size and didn’t benefit from a control group.

However, more recent studies — which focused on women who have sexual dysfunction in addition to other conditions — have yielded stronger evidence.

For example, a randomized controlled trial examined the effects of yoga in women with metabolic syndrome, a population with a higher risk of sexual dysfunction overall.

For these women, a 12-week yoga program led to “significant improvement” in arousal and lubrication, whereas such improvements were not seen in the women who did not practice yoga.

Improvements were also found in blood pressure, prompting the researchers to conclude that “yoga may be an effective treatment for sexual dysfunction in women with metabolic syndrome as well as for metabolic risk factors.”

Another randomized trial looked at the sexual benefits of yoga for women living with multiple sclerosis (MS). The participants undertook 3 months of yoga training, consisting of eight weekly sessions.

Importantly, women in the yoga group “showed improvement in physical ability” and sexual function, “while women in [the] control group manifested exacerbated symptoms.”

“Yoga techniques may improve physical activities and sexual satisfaction function of women with MS,” the study paper concluded.

So, while we need more scientific evidence to support yoga’s benefits for our sex lives, the seeds are definitely there. Until future research can ascertain whether “yogasms” are a real, achievable thing, we think that there’s enough reason to incorporate yoga in our daily routines.

Trying it out for ourselves could prove tremendously enriching — and our pelvic muscles will definitely thank us for it.

Chronic stress may raise obesity risk

All of us become stressed at points in our lives, and it is well established that stress can take its toll on physical and mental well-being. New research strengthens the link between long-term stress and increased risk of obesity.
[A woman on a set of scales]

Chronic stress may raise the risk of obesity, research suggests.

Researchers found that individuals who had persistently high levels of the “stress hormone” cortisol over long periods of time weighed more, had a higher body mass index (BMI), and a larger waist, compared with those who had low levels of the hormone.

The study – led by Dr. Sarah Jackson from the Department of Epidemiology and Public Health at University College London (UCL) in the United Kingdom – was recently published in the journal Obesity.

Obesity has become an epidemic in the United States, affecting more than a third of adults.

Past research has shown that stress can fuel obesity; stress has been linked to “comfort eating,” whereby individuals turn to foods high in fat and sugar in an attempt to make them feel better.

Studies have also suggested cortisol – a hormone released in response to stress – plays a role in obesity and metabolic syndrome.

Hair cortisol levels used to assess stress-obesity link

For their study, Dr. Jackson and colleagues sought to determine how chronic stress influenced the risk of obesity. They did so by analyzing cortisol levels in hair samples of 2,527 adults aged 54 years and older who were part of the English Longitudinal Study of Ageing.

“Hair cortisol is a relatively new measure which offers a suitable and easily obtainable method for assessing chronically high levels of cortisol concentrations in weight research and may therefore aid in further advancing understanding in this area,” notes Dr. Jackson.

Also, hair sampling allows researchers to get a more accurate, longer-term picture of cortisol levels; many studies measure cortisol levels in blood, saliva, or urine, and these often vary by time of day and other factors.

“The analysis of cortisol in scalp hair reflects systemic cortisol exposure over a prolonged period – in this study, 2 months – and is therefore not affected by the timing of sample collection or acute stress,” say the authors.

The researchers took a lock of hair from each subject that measured at least 2 centimeters in length and 10 milligrams in weight. The hair was cut as near to the scalp as possible, representing around 2 months of hair growth.

Additionally, the team measured the weight, BMI, and waist circumference of each participant at several points over 4 years.

‘Consistent evidence that chronic stress is linked to obesity’

Compared with adults who had lower levels of hair cortisol, those who had higher levels were found to have a larger waist circumference, a higher BMI, and a heavier weight.

Adults considered obese based on their BMI or waist circumference – defined as greater than 102 centimeters in men and greater than 88 centimeters in women – had the highest hair cortisol levels, the team reports.

Based on their results, the researchers suggest long-term stress – as determined by cortisol levels in hair – may raise the risk of obesity.

These results provide consistent evidence that chronic stress is associated with higher levels of obesity.

People who had higher hair cortisol levels also tended to have larger waist measurements, which is important because carrying excess fat around the abdomen is a risk factor for heart disease, diabetes, and premature death.”

Dr. Sarah Jackson

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