Advertisement

Archives of Sexual Behavior

, Volume 48, Issue 1, pp 383–395 | Cite as

Three Reasons to Consider the Role of Tiredness in Sexual Risk-Taking Among Gay and Bisexual Men

  • Brett M. Millar
  • Tyrel J. Starks
  • H. Jonathon Rendina
  • Jeffrey T. ParsonsEmail author
Original Paper

Abstract

Numerous factors have been shown to increase sexual risk-taking—especially among gay and bisexual men (GBM), who remain disproportionately affected by HIV and STIs. We present three lines of evidence that highlight the need to consider a previously under-explored situational factor in sexual risk-taking: tiredness. While tiredness has been shown, in sleep science literature, to impair cognition, emotional functioning, and decision-making in a wide range of behaviors, it has yet to be considered in-depth as a risk factor in sexual behavior. Counter to the common-sense assumption that being tired should impede the performance of active, effortful behaviors such as sex, we propose that tiredness may actually increase sexual risk-taking. Analyzing data from an online survey of 1113 HIV-negative GBM, we found that sex with casual partners most commonly occurred at night, especially among younger GBM and those with an evening chronotype, and that sex without condoms more often occurred at or later than one’s usual time of feeling tired (as was reported by 44.2% of men) than did sex with condoms (reported by 36.6%). We also found that tiredness can increase sexual desire in many GBM (endorsed by 29.9%), and increases the likelihood of engaging in receptive positioning in anal sex (endorsed by almost 40% of men with a versatile sexual positioning identity). These findings highlight the importance of considering tiredness as a situational risk factor in sexual health—especially among younger GBM—and of counting sex among the behaviors that can be adversely impacted by poor or overdue sleep.

Keywords

Sleep Men who have sex with men (MSM) HIV Sexually transmitted infections (STIs) Sexual risk-taking Sexual orientation 

Notes

Acknowledgements

The authors would like to acknowledge the contributions of the other members of the One Thousand Strong Study Team (Dr. Christian Grov, Demetria Cain, Mark Pawson, Ruben Jimenez, Chloe Mirzayi, Raymond Moody, and Thomas Whitfield) and other staff from the Center for HIV/AIDS Educational Studies and Training (Chris Hietikko, Brian Salfas, Kendell Doyle, and Carlos Ponton). Thank you to Dr. Cheryl Carmichael and Dr. Dustin Duncan. We would also like to thank the staff at Community Marketing Inc (David Paisley, Heather Torch, and Thomas Roth). Finally, we thank Jeffrey Schulden at NIDA and all of our participants in the One Thousand Strong study.

Funding

The One Thousand Strong study was funded by a research grant from the National Institute on Drug Abuse (R01 DA036466: Jeffrey T. Parsons & Christian Grov, MPIs). H. Jonathon Rendina was funded in part by a Career Development Award from the National Institute on Drug Abuse (K01-DA039030; H. Jonathon Rendina, PI). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflicts of interest.

References

  1. Adan, A., & Almirall, H. (1991). Horne & Östberg Morningness-Eveningness Questionnaire: A reduced scale. Personality and Individual Differences, 12(3), 241–253.CrossRefGoogle Scholar
  2. Adan, A., Archer, S. N., Hidalgo, M. P., Di Milia, L., Natale, V., & Randler, C. (2012). Circadian typology: A comprehensive review. Chronobiology International, 29(9), 1153–1175.CrossRefGoogle Scholar
  3. Allen, M. S., & Desille, A. E. (2017). Health-related lifestyle factors and sexual functioning and behavior in older adults. International Journal of Sexual Health, 29(3), 273–277.CrossRefGoogle Scholar
  4. Barak, Y., Stein, D., Ring, A., Ticher, A., & Elizur, A. (1997). Patterns of first intercourse: A survey among Israeli women. Biological Rhythm Research, 28(1), 36–41.CrossRefGoogle Scholar
  5. Barber, L. K. (2014). Conceptualizations of sleep in stress theory: Exciting new directions. Stress and Health, 30(5), 431–432.CrossRefGoogle Scholar
  6. Brown, F. C., Buboltz, W. C., & Soper, B. (2002). Relationship of sleep hygiene awareness, sleep hygiene practices, and sleep quality in university students. Behavioral Medicine, 28(1), 33–38.CrossRefGoogle Scholar
  7. Budweiser, S., Enderlein, S., Jörres, R. A., Hitzl, A. P., Wieland, W. F., Pfeifer, M., & Arzt, M. (2009). Men’s sexual health: Sleep apnea is an independent correlate of erectile and sexual dysfunction. Journal of Sexual Medicine, 6(11), 3147–3157.CrossRefGoogle Scholar
  8. Centers for Disease Control and Prevention. (2012). HIV transmission risk, 2012. http://www.cdc.gov/hiv/law/pdf/Hivtranmsmision.pdf. Accessed May 1, 2016.
  9. Centers for Disease Control and Prevention. (2015). Insufficient sleep is a public health epidemic. https://www.cdc.gov/features/dssleep/index.html. Accessed June 1, 2017.
  10. Centers for Disease Control and Prevention. (2016). HIV Surveillance Report, 2015 (Vol. 27). http://www.cdc.gov/hiv/library/reports/surveillance/html. Accessed 15 June 2017.
  11. Cooper, M. L. (2010). Toward a person × situation model of sexual risk-taking behaviors: Illuminating the conditional effects of traits across sexual situations and relationship contexts. Journal of Personality and Social Psychology, 98(2), 319–341.CrossRefGoogle Scholar
  12. Costa, R. M., & Oliveira, T. F. (2016). Poorer subjective sleep quality is related to higher fantasy-induced sexual arousal in women of reproductive age. Journal of Sex and Marital Therapy, 42(8), 740–748.CrossRefGoogle Scholar
  13. Curtis, J., Burkley, E., & Burkley, M. (2014). The rhythm is gonna get you: The influence of circadian rhythm synchrony on self-control outcomes. Social and Personality Psychology Compass, 8(11), 609–625.CrossRefGoogle Scholar
  14. Duarte, L. L., Menna-Barreto, L., Miguel, M. A. L., Louzada, F., Araújo, J., Alam, M., & Pedrazzoli, M. (2014). Chronotype ontogeny related to gender. Brazilian Journal of Medical and Biological Research, 47(4), 316–320.CrossRefGoogle Scholar
  15. Duncan, D. T., Goedel, W. C., Mayer, K. H., Safren, S. A., Palamar, J. J., Hagen, D., & Jean-Louis, G. (2016). Poor sleep health and its association with mental health, substance use, and condomless anal intercourse among gay, bisexual, and other men who have sex with men. Sleep Health, 2(4), 316–321.CrossRefGoogle Scholar
  16. Durmer, J. S., & Dinges, D. F. (2005). Neurocognitive consequences of sleep deprivation. Seminars in Neurology, 25(1), 117–129.CrossRefGoogle Scholar
  17. Engle-Friedman, M. (2014). The effects of sleep loss on capacity and effort. Sleep Science, 7(4), 213–224.CrossRefGoogle Scholar
  18. Engle-Friedman, M., Riela, S., Golan, R., Ventuneac, A. M., Davis, C. M., Jefferson, A. D., & Major, D. (2003). The effect of sleep loss on next day effort. Journal of Sleep Research, 12(2), 113–124.CrossRefGoogle Scholar
  19. Fillo, J., Alfano, C. A., Paulus, D. J., Smits, J. A., Davis, M. L., Rosenfield, D., & Baird, S. O. (2016). Emotion dysregulation explains relations between sleep disturbance and smoking quit-related cognition and behaviour. Addictive Behaviors, 57, 6–12.CrossRefGoogle Scholar
  20. Forman, E. M., Schumacher, L. M., Crosby, R., Manasse, S. M., Goldstein, S. P., Butryn, M. L., & Thomas, J. G. (2017). Ecological momentary assessment of dietary lapses across behavioral weight loss treatment: Characteristics, predictors, and relationships with weight change. Annals of Behavioral Medicine, 51, 1–13.CrossRefGoogle Scholar
  21. Goedel, W. C., & Duncan, D. T. (2015). Geosocial-networking app usage patterns of gay, bisexual, and other men who have sex with men: Survey among users of Grindr, a mobile dating app. JMIR, Public Health & Surveillance, 1(1), e4–e16.  https://doi.org/10.2196/publichealth.4353.CrossRefGoogle Scholar
  22. Greer, S. M., Goldstein, A. N., & Walker, M. P. (2013). The impact of sleep deprivation on food desire in the human brain. Nature Communications, 4(1), 2259.  https://doi.org/10.1038/ncomms3259.CrossRefPubMedPubMedCentralGoogle Scholar
  23. Grov, C., Cain, D., Whitfield, T. H., Rendina, H. J., Pawson, M., Ventuneac, A., & Parsons, J. T. (2016). Recruiting a US national sample of HIV-negative gay and bisexual men to complete at-home self-administered HIV/STI testing and surveys: Challenges and opportunities. Sexuality Research and Social Policy, 13(1), 1–21.CrossRefGoogle Scholar
  24. Gunia, B. C., Barnes, C. M., & Sah, S. (2014). The morality of larks and owls: Unethical behavior depends on chronotype as well as time of day. Psychological Science, 25(12), 2272–2274.CrossRefGoogle Scholar
  25. Hagger, M. S. (2014). Where does sleep fit in models of self-control and health behaviour. Stress Health, 30, 425–430.CrossRefGoogle Scholar
  26. Horne, J. A., & Östberg, O. (1975). A self-assessment questionnaire to determine morningness–eveningness in human circadian rhythms. International Journal of Chronobiology, 4(2), 97–110.Google Scholar
  27. Jankowski, K. S., Díaz-Morales, J. F., & Randler, C. (2014). Chronotype, gender, and time for sex. Chronobiology International, 31(8), 911–916.CrossRefGoogle Scholar
  28. Kahn, M., Sheppes, G., & Sadeh, A. (2013). Sleep and emotions: Bidirectional links and underlying mechanisms. International Journal of Psychophysiology, 89(2), 218–228.CrossRefGoogle Scholar
  29. Kling, J. M., Manson, J. E., Naughton, M. J., Temkit, M. H., Sullivan, S. D., Gower, E. W., & Crandall, C. J. (2017). Association of sleep disturbance and sexual function in postmenopausal women. Menopause, 24(6), 604–612.CrossRefGoogle Scholar
  30. Lin, H. H., Ho, F. M., Chen, Y. F., Tseng, C. M., Ho, C. C., & Chung, W. S. (2015). Increased risk of erectile dysfunction among patients with sleep disorders: A nationwide population-based cohort study. International Journal of Clinical Practice, 69(8), 846–852.CrossRefGoogle Scholar
  31. Lyons, A., Pitts, M., Smith, G., Grierson, J., Smith, A., McNally, S., & Couch, M. (2011). Versatility and HIV vulnerability: Investigating the proportion of Australian gay men having both insertive and receptive anal intercourse. Journal of Sexual Medicine, 8(8), 2164–2171.CrossRefGoogle Scholar
  32. Manly, T., Lewis, G. H., Robertson, I. H., Watson, P. C., & Datta, A. K. (2002). Coffee in the cornflakes: Time-of-day as a modulator of executive response control. Neuropsychologia, 40(1), 1–6.CrossRefGoogle Scholar
  33. McKee, H. C., Ntoumanis, N., & Taylor, I. M. (2014). An ecological momentary assessment of lapse occurrences in dieters. Annals of Behavioral Medicine, 48(3), 300–310.CrossRefGoogle Scholar
  34. McKnight-Eily, L. R., Eaton, D. K., Lowry, R., Croft, J. B., Presley-Cantrell, L., & Perry, G. S. (2011). Relationships between hours of sleep and health-risk behaviors in US adolescent students. Preventive Medicine, 53(4), 271–273.CrossRefGoogle Scholar
  35. Metcalfe, J., & Mischel, W. (1999). A hot/cool system analysis of delay of gratification: Dynamics of willpower. Psychological Review, 106, 3–19.CrossRefGoogle Scholar
  36. Millar, B. M. (2017). Clocking self-regulation: Why time of day matters for health psychology. Health Psychology Review, 11(4), 345–357.CrossRefGoogle Scholar
  37. Palmer, C. A., & Alfano, C. A. (2017). Sleep and emotion regulation: An organizing, integrative review. Sleep Medicine Reviews, 31, 6–16.CrossRefGoogle Scholar
  38. Palmer, J. D., Udry, J. R., & Morris, N. M. (1982). Diurnal and weekly, but no lunar rhythms in human copulation. Human Biology, 54(1), 111–121.PubMedGoogle Scholar
  39. Pejovic, S., Vgontzas, A. N., Basta, M., Tsaoussoglou, M., Zoumakis, E., Vgontzas, A., & Chrousos, G. P. (2010). Leptin and hunger levels in young healthy adults after one night of sleep loss. Journal of Sleep Research, 19(4), 552–558.CrossRefGoogle Scholar
  40. Perogamvros, L., & Schwartz, S. (2015). Sleep and emotional functions. Current Topics in Behavioral Neurosciences, 25, 411–431.CrossRefGoogle Scholar
  41. Randler, C. (2016). Ontogeny of morningness–eveningness across the adult human lifespan. The Science of Nature, 103(1–2), 3–6.CrossRefGoogle Scholar
  42. Randler, C., Jankowski, K. S., Rahafar, A., & Díaz-Morales, J. F. (2016). Sociosexuality, morningness–eveningness, and sleep duration. SAGE Open, 6(1), 1–8.CrossRefGoogle Scholar
  43. Refinetti, R. (2005). Time for sex: Nycthemeral distribution of human sexual behavior. Journal of Circadian Rhythms, 3(1), 4–7.CrossRefGoogle Scholar
  44. Rendina, H. J. (2015). When parsimony is not enough: Considering dual processes and dual levels of influence in sexual decision making. Archives of Sexual Behavior, 44(7), 1937–1947.CrossRefGoogle Scholar
  45. Roenneberg, T., Kuehnle, T., Juda, M., Kantermann, T., Allebrandt, K., Gordijn, M., & Merrow, M. (2007). Epidemiology of the human circadian clock. Sleep Medicine Reviews, 11(6), 429–438.CrossRefGoogle Scholar
  46. Schmidt, C., Collette, F., Cajochen, C., & Peigneux, P. (2007). A time to think: Circadian rhythms in human cognition. Cognitive Neuropsychology, 24(7), 755–789.CrossRefGoogle Scholar
  47. Terre, L. (2014). Clinical implications of impaired sleep. American Journal of Lifestyle Medicine, 8(6), 352–370.CrossRefGoogle Scholar
  48. van der Helm, E., & Walker, M. P. (2012). Sleep and affective brain regulation. Social and Personality Psychology Compass, 6(11), 773–791.CrossRefGoogle Scholar
  49. Venkatraman, V., Chuah, Y. L., Huettel, S. A., & Chee, M. W. (2007). Sleep deprivation elevates expectation of gains and attenuates response to losses following risky decisions. Sleep, 30(5), 603–609.CrossRefGoogle Scholar
  50. Watson, D., Wiese, D., Vaidya, J., & Tellegen, A. (1999). The two general activation systems of affect: Structural findings, evolutionary considerations, and psychobiological evidence. Journal of Personality and Social Psychology, 76(5), 820–838.CrossRefGoogle Scholar
  51. Womack, S. D., Hook, J. N., Reyna, S. H., & Ramos, M. (2013). Sleep loss and risk-taking behavior: A review of the literature. Behavioral Sleep Medicine, 11(5), 343–359.CrossRefGoogle Scholar
  52. Zarcone, V., de la Pena, A., & Dement, W. C. (1974). Heightened sexual interest and sleep disturbance. Perceptual and Motor Skills, 39(3), 1135–1141.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Brett M. Millar
    • 1
    • 2
  • Tyrel J. Starks
    • 1
    • 2
    • 3
  • H. Jonathon Rendina
    • 1
    • 2
    • 3
  • Jeffrey T. Parsons
    • 1
    • 2
    • 3
    Email author
  1. 1.Health Psychology and Clinical Science Doctoral ProgramThe Graduate Center of the City University of New YorkNew YorkUSA
  2. 2.Center for HIV/AIDS Educational Studies and TrainingHunter College of the City University of New YorkNew YorkUSA
  3. 3.Department of PsychologyHunter College of the City University of New YorkNew YorkUSA

Personalised recommendations