Sleep Basics - 101 Questions About Sleep and Dreams

Chapter 3 - Sex

22. My bedpartner's penis sometimes gets erect when he sleeps. This happens even after we have had sex. Does this mean he is not satisfied or wants someone else?
23. Is there a female counterpart to erections during sleep in men?
24. Is sex good for your sleep?
25. I have heard that women have more insomnia than men. Men seem to be less excitable than women. Do men sleep better than women?

22. Q: My bedpartner's penis sometimes gets erect when he sleeps. This happens even after we have had sex. Does this mean he is not satisfied or wants someone else?

Males normally have erections (penile tumescence) during their sleep. The erections come 4 - 5 times a night about the time when dreaming or REM sleep occurs. As far as scientists know, the subject matter of the dream does not predict whether or not there will be an erection. The erections are a normal part of REM sleep for males of all ages. Doctors may record the circumference of a man's penis all night long to check for the presence, size and duration of erections. Such erections are called episodes of Nocturnal Penile Tumescence (NPT). It is now recognized that erectile dysfunction (impotence) may be caused by a variety of physiological conditions - such as damage to the nerves that regulate blood flow into the penis. NPT recordings may be done to determine, independent of psychological factors, the extent of a man's erectile capability. This information can be used to select from the many treatments now available for erectile dysfunction, including, but not limited to, sildenafil (Viagra).

The relationship between REM sleep and erections is also the reason that men frequently wake up in the morning with an erection without having the desire to engage in sexual activity. There is a commonly held, but incorrect, belief that morning erections are due to a full urinary bladder. This belief really makes no sense. For example, men do not get erections during the day before urination. The correct explanation for morning erections involves the way nighttime sleep is organized. We have most of our REM sleep in the early morning, usually between 4 - 7 AM. Therefore, each morning we are very likely to awaken directly from REM sleep or, at the very least, soon after a long morning REM period has ended. Thus, men are very likely to awaken in the morning with a REM sleep-related erection.

23. Q: Is there a female counterpart to erections during sleep in men?

There does seem to be a female counterpart to penile tumescence during REM sleep. A number of studies indicate that vaginal and clitoral swelling do occur during the night in about the same time relationship to REM sleep as has been observed for penile erections in males. There are also reports that vaginal secretions increase during REM sleep. Moreover, there are reliable data showing that the rate of contractions of the uterus is highest during REM sleep and lowest during slow wave sleep. Doctors are now working on ways to use recordings of uterine contractions during sleep in their clinical evaluations of female sexual function, just as they use NPT in evaluations of male sexual function.

24. Q: Is sex good for your sleep?

Yes, at least, sex seems to help men sleep. Many men report that they use orgasm, either through sexual relations or masturbation, to aid in falling asleep. In male rats, there is an active inhibition of sexual behavior following ejaculation. During this period, the male rat emits an ultrasonic vocalization and the rat's EEG shows sleep-like activity. For women, the effect of sexual activity and orgasm is unpredictable. Many women report that sexual activity is alerting, rather than relaxing. Scientists have observed that, in female rabbits during their sexually receptive phases, sleep is increased after sexual intercourse with a male rabbit and after mechanical stimulation of the vagina without intercourse. However, women report that after sexual activity leading to orgasm, they feel more alert and sometimes annoyed with male partners who, after sex, seem simply to collapse and begin snoring. These different effects in men and women can lead to some discord in relationships. Appreciation that these differences are due to biological factors, rather than personality and insensitivity, may help heal hurt feelings.

25. Q: I have heard that women have more insomnia than men. Men seem to be less excitable than women. Do men sleep better than women?

This question sounds sexist, and even a bit silly. However, the answer is really much more serious than the question. Among people who complain of chronic insomnia over age 40, there are 7 or 8 women to 1 man. The reasons for the disproportionate number of women are not known. Menopause, grown children leaving home (the so-called, 'empty nest syndrome') and other life-cycle effects have been offered as explanations.

This most important point in connection with this question, however, is that across all ages, on the average, males sleep much worse than females. One of the main reasons is that many more males are prone to sleep-related breathing disorders than females. From birth on, male babies have more respiratory difficulties and succumb more often to sudden infant death syndrome than female babies. Physicians think that this is partly because the female hormone, progesterone, somehow protects females from respiratory difficulties during sleep. The man who brags that he can 'sleep through a bombing' may actually be abnormal. Rather than being so 'in control and relaxed' that he can 'sleep fine anywhere, anytime', this man may have such poor breathing and sleep disruption that he is too sleepy to stay fully alert. Such men cannot restrict their sleep to appropriate times of the 24-hour day. Finally, with age, the statistical score between the sexes evens up. As women pass through menopause, a variety of hormonal changes occur that seem to bring on sleep problems. Menopausal and post-menopausal women complain more of insomnia than men of comparable age. And, after the age of 65, the male-female differences for sleep-related breathing disorders become much smaller.

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