睡眠中的性行为(SBS)是一种相对罕见的失眠症,由在非快速眼动(NREM)睡眠期间发生的本能性行为组成。目前,关于这种疾病的临床特征和发病以及与精神病合并症的联系的信息很少。其他睡眠障碍和不良的早期生活经历史。目的是进一步表征该疾病,并将SBS患者的特征与其他NREM失眠症患者的特征进行比较。
方法:研究了335名连续患者的详细信息,这些患者在15年(2005-2020年)期间出现了非快速眼动(NREM)-非睡眠性睡眠。通过查看人体测量数据的案例注释来整理数据,既往病史,临床发现,和视频多导睡眠图。将SBS患者与270名非SBS患者进行了比较,NREM-睡眠障碍患者(病例对照),以确定他们是否具有与该组中分类的其他误视症的任何区别特征。
结果:确定了65例SBS患者:58例男性,7名女性(占整个队列的19.4%)。演示时的平均年龄为33(±9.5)岁。在SBS队列中,行为的发作在成年期普遍,而非SBS,NREM-失眠症发作(n=270)在儿童时期较为普遍:分别为61.1%和52.9%(p=0.007)。精神病诊断的存在与SBS的发作之间存在关联(p=0.028)。SBS行为的重要触发因素包括饮酒(p<0.001),亲密关系困难(p=0.009)和睡眠剥夺(p=0.028)。SBS患者更有可能将梦游报告为额外的NREM行为(p<0.001)。男性更有可能与床伴一起出现在诊所,而女性则单独出现。与非SBS的人相比,在武装部队或警察工作的人中SBS的历史似乎更为普遍,NREM-失眠症(p=0.004)。
结论:SBS在临床实践中比以前描述的更常见,并且在NREM障碍类别中具有一些显著特征。这项研究是第一个确定儿童期发作或缺乏健忘症并不排除这种情况,并且男女之间的表现方式不同。特别应该询问梦游者有关SBS的信息。共患精神病,职业和亲密伴侣的困难是演讲的强烈决定因素。
Sexualised behaviour in sleep (SBS) is a relatively rare parasomnia consisting of instinctive behaviours of a sexual nature occurring during non-rapid-eye movement (NREM) sleep. Little information exists at present regarding the clinical features and onset of this condition as well as its link to psychiatric comorbidity, other sleep disorders and history of adverse early life experience. Aims were to typify the condition further and compare features of SBS patients to those with other NREM
parasomnias.
METHODS: Details of 335 consecutive patients presenting to a single tertiary sleep centre with non-rapid eye movement (NREM)-
parasomnias over a 15-year period (2005-2020) were examined. Data were collated by reviewing
case-notes for anthropometric data, past medical history, clinical findings, and video polysomnography. SBS patients were compared to a cohort of 270 non-SBS, NREM-sleep disorder patients (
case-control) to ascertain whether they had any distinguishing features from other
parasomnias classified in this group.
RESULTS: Sixty-five patients with SBS were identified: 58 males, 7 females (comprising 19.4% of the cohort overall). Mean age at presentation was 33(±9.5) years. Onset of behaviours was commoner in adulthood in the SBS cohort, whereas non-SBS, NREM-parasomnia onset (n = 270) was commoner in childhood: 61.1% and 52.9% respectively (p = 0.007). An association was identified between the presence of psychiatric diagnoses and onset of SBS (p = 0.028). Significant triggers for SBS behaviours included alcohol consumption (p < 0.001), intimate relationship difficulties (p = 0.009) and sleep deprivation (p = 0.028). Patients with SBS were significantly more likely to report sleepwalking as an additional NREM behaviour (p < 0.001). Males were more likely to present at clinic together with their bedpartner and females presented alone. A history of SBS appeared to be more common in those working in the armed forces or the police compared to those presenting with non-SBS, NREM-parasomnias (p = 0.004).
CONCLUSIONS: SBS is more common in clinical practice than previously described and presents with some distinguishing features within the NREM disorder category. This study is the first to identify that onset in childhood or lack of amnesia does not preclude the condition and that patterns of presentation differ between men and women. Sleepwalkers particularly should be asked about SBS. Comorbid psychiatric conditions, profession and intimate partner difficulties are strong determinants of the presentation.