Somnophilia: When Sleeping Is Sexy

According to the current and fifth versions of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a paraphilia is an intense or persistent sexual interest in something other than "genital stimulation or preparatory fondling with phenotypically normal, physically mature, consenting human partners."

Common paraphilias are fetishism, or a preference for specific body parts or inanimate objects (such as safety pins — see my post "The Man Who Loved Safety Pins"); voyeurism, which involves spying on others in private activities; and exhibitionism, or exposing genitals.

Rarer and less known paraphilias include symphorophilia, or sexual pleasure from watching a disaster such as a car accident (as featured in JG Ballard’s novel Crash and its Oscar-winning 1996 film adaptation); formicophilia, or having insects crawl on your body; and infantilism, or dressing up or wanting to be treated like a baby, which can also involve diaperism, or deriving sexual pleasure from wearing a nappy.

Another rare paraphilia is somnophilia, also known as "sleeping beauty syndrome." It has been represented on-screen in the films Sleeping Beauty (2011) and The Little Death (2014), an Australian production that also portrays several other paraphilias.

In a case study of a man with somnophilia published by Swiss psychiatrist Francesco Bianchi-Demicheli and his colleagues in 2010, a link was made between this paraphilia and a childhood brain injury.

Jim, a 34-year-old man, arrived at an emergency psychiatric unit after physically assaulting his wife. His relationship with his wife had been strained for several years because over time he had developed "a particular and progressive sexual deviant behaviour": He felt sexually aroused by sleeping women, and liked to attend to their hands and nails while they slept and give them a manicure.

During the initial years of his marriage, he was able to control these fantasies but, the case study reports, "over the years he lost control of his sexual urges" and acted on them. Initially, Jim’s wife agreed to use sleeping pills to fulfill his desires, but she later refused to "bend to [the] man’s freakish will." That’s when he began to secretly administer benzodiazepines—minor tranquillisers typically prescribed to relieve anxiety and insomnia—to her.

When Jim’s wife discovered what he had been doing, their conflict began. It all came to a dramatic head when Jim "disguised himself with a latex mask and attacked his wife as she returned from work," using a capsicum spray to subdue her. His wife managed to pull off his mask, then ran out of the house and called the police.

The results of the psychiatric examination and routine laboratory tests were all normal. The only medical history of note was a traumatic brain injury Jim had suffered aged 10, after which he was reportedly in a coma for four days.

It doesn’t say how he sustained this injury, but an MRI brain scan showed that it caused damage to his right frontal and parietal regions, specifically "moderate atrophy in the frontoparietal region with a diffuse and severe white matter injury compatible with his previous head trauma." A neuropsychological assessment was said to show "moderate dysexecutive syndrome," which means he did not do so well on the tasks that examine frontal lobe functions, such as response control.

The frontal lobes control a complex array of social and emotional functions, but what do the parietal lobes do? They process sensory data that enable us to understand spatial information, including where our body is in space—in other words, "body awareness."

People with parietal lobe damage can have abnormalities in how they perceive their bodies, which is exactly what Jim showed: He had a fascinating and very specific body disorder characterized by an incomplete mental image of his hands, mostly the right, called "personal representational hemineglect." This was determined by the way he drew a picture of himself.

The authors concluded that Jim’s paraphilia "might be related to his disturbed body image and more specifically to the incomplete hands representation … presumably, the occurrence of head trauma might have played a critical role in the development of his sexual self and body image."

I’ve read many fascinating case studies about sex and the brain when doing research for my book Sex in the Brain, but this particular case was the only one that made me say "wow" out loud to my empty office.

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This is an adapted excerpt from Sex in the Brain: How Your Brain Controls Your Sex Life (NewSouth Publishing, 2019 & Columbia University Press, 2020).