User:Cdaniels26/Sexsomnia/Jeffbass75 Peer Review

General info

 * Whose work are you reviewing?

Cdaniels26


 * Link to draft you're reviewing
 * Sleep sex
 * Link to the current version of the article (if it exists)
 * Sleep sex

Evaluation
This article starts off with an accurate definition of Sexsomnia and separates it from other forms of parasomnia such as nocturnal sexual behaviors. A particular distinction is made between non-rapid eye movement (NREM) sleep and Rapid eye movement (REM) sleep which is important as these sleep patterns are known to be at varying levels of consciousness and overall brain activity. The beginning of the article could include some information about Sexsomnia rates amongst females, as this is unclear. Highest prevalence rates are important, but it holds minimal relevance if that specific value is unclear, along with a value to compare it with.

Classification of these disorders is important, and I like that she identified this disorder under DSM-5 criteria, as it reiterates that there may be a primary psychological component to consider. The bolded title "NREM arousal parasomnia" is unneeded however, as it is discussed in the previous sentence. Also, with how it reads it appears confusing where Sexsomnia fits as it would be in the arousal disorders category, but with the category of "parasomnias associated with REM sleep" it makes it appear that arousal disorders and REM sleep are mutually exclusive, which I am not sure is the case.

Symptoms covered are appropriate as they appear to cover some of the major ones, but it is worth considering that Sexsomnia may include symptoms such as fatigue, which would be evidenced by energy exerted while engaging in sexual behavior. The applied example provides a nice example of the presentation of people with Sexsomnia, as their presentation can make differential diagnosis difficult. It also presents a case for the importance of using reports other than self-report as since the individual is unconscious they would not be a good reporter of their experience.

Stress factors of Sexsomnia are important, but having the first bulletin be "stress factors" appears redundant to the title, and that bulletin is so broad that it could cover that entire section yet it does not. The portion that covers how sleep deprivation affects neurogeneration is good as since certain stages of sleep (such as REM sleep) occur less in the presence of Sexsomnia, less overall neurogeneration would occur as they differ from muscles. The section pertaining to how Sexsomnia can be triggered could be expanded, as it could cover other triggers such as psychological health.

The risk factors section appears to attempt to answer some of the previous comments, but I think that other disorders such as psychological disorders could be included in this section. I do like that physical contact with a partner was expanded in this section, as it clarifies that this physical contact is likely initiated from the person with Sexsomnia, as their sleep-related epilepsy disorder behaviors are the cause of contact. I like that medications were brought up, as it shows that medications would not inherently treat this condition as one would think as artificial attempts to induce deeper stages of sleep would be helpful. Again, with the prevalence rate, I appreciate the additional information pertaining to age discrepancies, but it is unclear if both men and women are discussed as the first mention of rates only included males.

The mechanism section pertaining to NREM sleep is nice as Sexsomnia has been identified as occurring during NREM sleep. It also brings relevance to how Sexsomnia may disproportionately affect the sleep cycle, as it gives an approximate (15-20%) for how much of one's sleep cycles are supposed to be. The section of stage 3 for slow wave sleep I feel could be expanded, as it is identified as the most important stage regarding parasomnias. Some research that could be interesting is to look at how sleep deprivations at these cycles would have an effect on Sexsomnia as opposed to only looking at the entire sleep cycle.

The disclaimer for diagnosis is important, as with many disorders in the DSM-5 such as Schizophrenia have no objectively definitive way to diagnose. The importance of polysomnography is covered sufficiently, as it can help immensely when comparing Sexsomnia to other sleep-related disorders such as epilepsy, sleep apnea, etc. I also like the inclusion of need for obtaining collateral information, as more than one test should be used in the decision making process of clinical evaluations.

The disclaimer for prevention is good to have, as it clarifies that there is not specific treatments available, but rather certain precautionary measures are best to minimize symptoms. I do feel that the medication section could be expanded to cover other psychiatric medications. For example, SSRIs (Selective Serotonin Reuptake Inhibitors) have the side effect of diminished sexual arousal, so it would be interesting to see if there is any literature pertaining to their efficacy in combination with or without benzodiazepines.

The following sections are important as they cover how recent attention has been directed towards understanding this condition, even though it has likely been going on throughout human history. Lastly, it is good that that consequences of diagnoses are considered, as significant legal complications could arise from overdiagnosis of Sexsomnia.