ye

Sexual assault is any kind of sexual activity, contact, or experience that happens without your consent. That means the sexual activity happens even though you don't agree to it.

Sexual assault may happen with:

• Physical force or threats of force
• Sexual coercion (being pressured, tricked, threatened, or forced in a nonphysical way to make you think you owe sex to someone)
• Alcohol or drugs, including date rape drugs

Sexual assault may also be called sexual violence or sexual abuse. It affects millions of people each year. Anyone can be a victim of sexual assault. Many victims first experience sexual assault during childhood. Most victims are girls and women. But many boys and men are also victims of sexual assault.

If you've been sexually assaulted, it's never your fault. It's something that happens to you.

Sexual assault is any unwanted sexual activity, including:

• Sexual activity with physical contact, which is everything from sexual touching or kissing to rape or attempted rape
• Sexual activity without physical contact, which includes things that may happen in person, online, or through texts, such as:
  • "Flashing" or exhibitionism (when someone shows you their genitals without asking you for permission)
  • Being forced to look at sexual images or pose for sexual photos
  • Being sent unwanted texts with sexual photos or messages
  • Voyeurism (when someone watches private sexual acts without permission)
  • Getting sexual threats or being sexually harassed (unwelcome sexual comments, requests for sexual favors, or other sexual behavior that's ongoing)

Any sexual activity that happens without your consent is sexual assault.

Giving your consent means that you clearly and freely say "yes" to sexual activity. Your consent means that you:

• Know and understand what's going on
• Can say what you want to do and don't want to do
• Are not underage
• Are not being pressured or tricked to do things you don't want to do

Giving consent is not:

• Silence. Not saying "no" doesn't mean you're saying "yes."
• Having consented in the past. Having said "yes" to sex with someone in the past doesn't mean that you've agreed to all sexual activity in the future. That's true when you're dating or in a lasting relationship.
• Being passive and not fighting off an attacker.

You cannot give consent if you are:

• Drugged, drunk, passed out, or asleep.
• Mentally unable to consent due to illness or disability.
• Underage (States have different laws about how old you must be to give legal consent to sexual activity.).
• Sexually coerced. This means that someone is pressuring you to take part in sexual activity. Agreeing to sex under pressure is not giving consent. The pressure may include:
  • Abusing power over you, for example, a boss threatening your job.
  • Making threats to harm people you care about.
  • Making false promises to reward you for sex.
  • Threatening to end a relationship or spread rumors about you.
  • Wearing you down by constantly asking for sex or making you feel guilty or obligated.

Both men and women commit sexual assault. A person who commits sexual assault may be a stranger, but more often it's someone you know, for example:

• A friend or acquaintance
• Someone you work with
• A neighbor
• A family member
• A current or past romantic partner, including a spouse

Sexual assault may have many health effects. Many of them can affect your lifelong health and well-being. The effects may include:

• Physical effects such as:
  • Bruises or genital injuries
  • Sexually transmitted infections (STIs)
  • Pregnancy
  • Ongoing problems with:
    • Female reproductive health
    • Digestive disorders
    • Your heart
    • Sexual health
• Psychological effects such as:
  • Depression or anxiety
  • Thoughts about suicide
  • Post-traumatic stress disorder (PTSD)

Sexual assault victims are more likely to smoke, have an alcohol use disorder (AUD), use illegal drugs, and have risky sexual behavior. Girls who experience sexual violence are more likely to become victims of intimate partner violence in adulthood.

If you are in danger or need medical care, call 911. If you can, get away from the person who assaulted you and get to a safe place as fast as you can.

You can call the National Sexual Assault Hotline at 800-656-HOPE (4673) to connect with a sexual assault service provider in your area who can direct you to local resources.

Getting support after a sexual assault may help you cope better and reduce the long-term effects. Victim services like rape crisis centers may offer a safe, healing place where you can find support.

Studies show that treatments such as Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) can help victims cope with depression, anxiety, and post-traumatic stress disorder.

Sexual assault is never the victim's fault. No one who has been assaulted should be blamed for something that they did or did not do.

You can take some steps to try to be safer around others:

• Go to parties with friends. Look out for each other. If a friend seems drunk or drugged, get them to a safe place. Have a plan for how you'll get home, too.
• Keep control of your drink. Someone could add alcohol or put a drug in it without you knowing.
• Meet people for the first time in a public place.
• Listen to your "gut feelings." If you feel uncomfortable around someone, leave.
• Pay attention to your surroundings. When walking alone, stay in busy well-lit areas. And don't wear headphones; you want to be able to hear what's happening around you.

Centers for Disease and Control and Prevention

For most adults, moderate alcohol use is probably not harmful. Your risk of developing an alcohol use disorder (AUD) depends on how much, how often, and how quickly you drink alcohol. Alcohol misuse means that drinking causes distress and harm. Over time alcohol misuse can increase your risk of AUD.

AUD can range from mild to severe, depending on the symptoms. Severe AUD is sometimes called alcoholism or alcohol dependence.

AUD is a disease that causes:

• Craving - a strong need to drink
• Loss of control - not being able to stop drinking once you've started
• Negative emotional state - feeling anxious and irritable when you are not drinking

Binge drinking is a type of alcohol misuse. It means drinking so much at once that your blood alcohol concentration (BAC) level is 0.08% or more. For a man, this usually happens after having 5 or more drinks within a few hours. For a woman, it is after about 4 or more drinks within a few hours. Not everyone who binge drinks has an AUD, but they are at higher risk for getting one.

Too much alcohol is dangerous. Heavy drinking can increase the risk of certain cancers. It may lead to liver diseases, such as fatty liver disease and cirrhosis. It can also cause damage to the brain and other organs. Drinking during pregnancy can harm your fetus. Alcohol also increases the risk of death from car crashes, injuries, homicide, and suicide.

You may have an AUD if you can answer yes to two or more of these questions:

In the past year, have you:

• Ended up drinking more or for a longer time than you had planned to?
• Wanted to cut down or stop drinking, or tried to, but couldn't?
• Spent a lot of your time drinking or recovering from drinking?
• Felt a strong need to drink?
• Found that drinking - or being sick from drinking - often interfered with your family life, job, or school?
• Kept drinking even though it was causing trouble with your family or friends?
• Given up or cut back on activities that you enjoyed just so you could drink?
• Gotten into dangerous situations while drinking or after drinking? Some examples are driving drunk and having unsafe sex.
• Kept drinking even though it was making you feel depressed or anxious? Or when it was adding to another health problem?
• Had to drink more and more to feel the effects of the alcohol?
• Had withdrawal symptoms when the alcohol was wearing off? They include trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, and sweating. In severe cases, you could have a fever, seizures, or hallucinations.

If you have any of these symptoms, your drinking may already be a cause for concern. The more symptoms you have, the more serious the problem is.

If you think you might have an AUD, see your health care provider for an evaluation. Your provider can help make a treatment plan, prescribe medicines, and if needed, give you treatment referrals.

NIH: National Institute on Alcohol Abuse and Alcoholism

While you are sleeping your brain and body functions are still active. Sleep is a natural process that helps your body restore energy, supports learning and memory, and keeps you healthy.

During sleep, your brain cycles through different stages of non-rapid eye movement (non-REM) sleep and rapid eye movement (REM) sleep. Non-REM sleep has three stages that range from light to deep sleep, while REM sleep is when most dreaming occurs. During each stage, your brain waves, breathing, heart rate, and body temperature change throughout the night. Certain phases of sleep help you:

• Feel rested and energetic the next day.
• Learn new information, get insight, and form memories.
• Give your heart and blood vessels a rest.
• Release growth hormone, which helps children grow and assists in muscle repair and tissue healing for everyone.
• Release sex hormones, which contribute to puberty and fertility.
• Maintain a healthy balance of hormones that control hunger and fullness.
• Strengthen your immune system by producing cytokines (hormones that help the body fight infection).

You need all the stages to get a healthy sleep.

The amount of sleep you need depends on your age, lifestyle, health, and sleep patterns. The general recommendations for sleep are:

• Babies (4-12 months): 12-16 hours a day (including naps)
• Children (1-2 years): 11-14 hours a day (including naps)
• Children (3-5 years): 10-13 hours a day (including naps)
• Children (6-12 years): 9-12 hours a day
• Teens (13-18 years): 8-10 hours a day
• Adults (18 years and older): 7-9 hours a day

During puberty, teenagers' biological clocks shift. They tend to fall asleep later and wake up later, which can conflict with the early school start times. This is one reason many teenagers don't get enough sleep.

Some people think adults need less sleep as they age, but there is no evidence to support this. However, older adults often get less sleep or spend less time in the deep, restful stages of sleep. They also wake up more easily.

It's not just the number of hours of sleep you get that matters. The quality of the sleep you get is also important. People whose sleep is frequently interrupted might not get enough of certain stages of sleep. If you are wondering whether you are getting enough sleep, including quality sleep, ask yourself:

• Do I have trouble getting up in the morning?
• Do I have trouble focusing during the day?
• Do I doze off during the day?

If you answered yes to any of these questions, you may need to improve your sleep habits.

Sleep is important for overall health. When you don't get enough sleep (sleep deprivation), it does more than just make you feel tired. It can impair your ability to think clearly, react quickly, and form memories. This increases your risk of making mistakes, taking risks, or getting into accidents.

Sleep deprivation can also affect your mood, leading to:

• Irritability
• Problems with relationships, especially for children and teenagers
• Depression
• Anxiety

It can also affect your physical health. Not getting enough sleep, or getting poor-quality sleep, increases your risk of:

• High blood pressure
• Heart disease
• Stroke
• Kidney disease
• Obesity
• Type 2 diabetes

Not getting enough sleep can also lower your levels of hormones that help children grow and help the body build muscle, repair tissue, and fight infections.

Sleep deprivation also magnifies the effect of alcohol. A tired person who drinks too much alcohol will be more impaired than a well-rested person who drinks the same amount.

You can take steps to improve your sleep habits. First, make sure that you allow yourself enough time for sleep. Getting enough sleep each night may help you feel happier and more productive during the day.

To improve your sleep habits, it also may help to:

• Go to bed and wake up at the same time every day.
• Avoid caffeine, especially in the afternoon and evening.
• Avoid nicotine.
• Exercise regularly, but not too close to bedtime.
• Avoid alcoholic drinks before bed.
• Avoid large meals and drinks late at night.
• Don't take a nap after 3 p.m.
• Relax before bed by taking a bath, reading or listening to calm music.
• Keep your bedroom cool, dark, and quiet.
• Get rid of distractions such as TVs, computers, and phones.
• Get enough sunlight exposure during the day.
• If you can't fall asleep for 20 minutes, get up and do something relaxing.
• See a health care provider if you have continued trouble sleeping. You may have a sleep disorder, such as insomnia or sleep apnea. In some cases, your provider may suggest trying a sleep study or other treatments.

If you are a shift worker, getting good sleep can be more challenging. You may also want to:

• Take naps and extend your total sleep time
• Keep the lights bright at work
• Limit shift changes to help your body adjust
• Limit caffeine to the first part of your shift
• Remove sound and light distractions in your bedroom during daytime sleep (for example, use light-blocking curtains or earplugs)