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Research ArticleRegular Article

Forensic Evaluation of Sexsomnia

Brian J. Holoyda, Renée M. Sorrentino, Amir Mohebbi, Antonio T. Fernando and Susan Hatters Friedman
Journal of the American Academy of Psychiatry and the Law Online February 2021, JAAPL.200077-20; DOI: https://doi.org/10.29158/JAAPL.200077-20
Brian J. Holoyda
Martinez Detention Facility, Martinez, CA, and Psychiatrist, Full Spectrum Health Services, Las Vegas, NV. , Institute of Sexual Wellness, Weymouth, MA, and , Harvard School of Medicine, Boston, MA. , Mission Viejo, CA. , Department of Psychological Medicine, University of Auckland, Auckland, New Zealand. , Case Western Reserve University, Department of Psychiatry, Cleveland, OH.
MD, MPH, MBA
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Renée M. Sorrentino
Martinez Detention Facility, Martinez, CA, and Psychiatrist, Full Spectrum Health Services, Las Vegas, NV. , Institute of Sexual Wellness, Weymouth, MA, and , Harvard School of Medicine, Boston, MA. , Mission Viejo, CA. , Department of Psychological Medicine, University of Auckland, Auckland, New Zealand. , Case Western Reserve University, Department of Psychiatry, Cleveland, OH.
MD
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Amir Mohebbi
Martinez Detention Facility, Martinez, CA, and Psychiatrist, Full Spectrum Health Services, Las Vegas, NV. , Institute of Sexual Wellness, Weymouth, MA, and , Harvard School of Medicine, Boston, MA. , Mission Viejo, CA. , Department of Psychological Medicine, University of Auckland, Auckland, New Zealand. , Case Western Reserve University, Department of Psychiatry, Cleveland, OH.
MD
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Antonio T. Fernando
Martinez Detention Facility, Martinez, CA, and Psychiatrist, Full Spectrum Health Services, Las Vegas, NV. , Institute of Sexual Wellness, Weymouth, MA, and , Harvard School of Medicine, Boston, MA. , Mission Viejo, CA. , Department of Psychological Medicine, University of Auckland, Auckland, New Zealand. , Case Western Reserve University, Department of Psychiatry, Cleveland, OH.
MD
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Susan Hatters Friedman
Martinez Detention Facility, Martinez, CA, and Psychiatrist, Full Spectrum Health Services, Las Vegas, NV. , Institute of Sexual Wellness, Weymouth, MA, and , Harvard School of Medicine, Boston, MA. , Mission Viejo, CA. , Department of Psychological Medicine, University of Auckland, Auckland, New Zealand. , Case Western Reserve University, Department of Psychiatry, Cleveland, OH.
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Abstract

Sexsomnia is a non-rapid eye movement parasomnic behavior characterized by sexual activity during sleep. Recognized in the most recent editions of the Diagnostic and Statistical Manual of Mental Disorders and the International Classification of Sleep Disorders, sexsomnia is likely to arise with increasing frequency in court as a potential explanation for sexual offending. The forensic psychiatrist has a unique role in the evaluation and management of sexsomnia. The psychosexual evaluation may elucidate the presence or absence of paraphilias and paraphilic disorders and identify any overlap between the alleged sexsomnic behavior and paraphilic interest. In addition, forensic psychiatrists may assess for malingered sexsomnia, provide an opinion regarding criminal responsibility, or evaluate the risk for committing future sexual offenses. Forensic psychiatrists should therefore understand basic information regarding the disorder, as well as how to conduct a psychosexual evaluation effectively in cases of alleged sexsomnia. This article describes the various considerations involved in the forensic evaluation of sexsomnia.

  • sexsomnia
  • sleep-related sexual behavior
  • parasomnia
  • paraphilia
  • paraphilic disorder
  • sexual offending

Footnotes

  • Disclosures of financial or other potential conflicts of interest: None.

  • © 2021 American Academy of Psychiatry and the Law
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Journal of the American Academy of Psychiatry and the Law Online: 53 (2)
Journal of the American Academy of Psychiatry and the Law Online
Vol. 53, Issue 2
1 Jun 2025
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Forensic Evaluation of Sexsomnia
Brian J. Holoyda, Renée M. Sorrentino, Amir Mohebbi, Antonio T. Fernando, Susan Hatters Friedman
Journal of the American Academy of Psychiatry and the Law Online Feb 2021, JAAPL.200077-20; DOI: 10.29158/JAAPL.200077-20

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Forensic Evaluation of Sexsomnia
Brian J. Holoyda, Renée M. Sorrentino, Amir Mohebbi, Antonio T. Fernando, Susan Hatters Friedman
Journal of the American Academy of Psychiatry and the Law Online Feb 2021, JAAPL.200077-20; DOI: 10.29158/JAAPL.200077-20
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Keywords

  • sexsomnia
  • sleep-related sexual behavior
  • parasomnia
  • paraphilia
  • paraphilic disorder
  • sexual offending

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