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)
• 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 participate 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 diseases
  • 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 provide 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. However, about 18 million adult Americans have an alcohol use disorder (AUD). This means that their drinking causes distress and harm. 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 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 baby. 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, you are unconscious, but your brain and body functions are still active. Sleep is a complex biological process that helps you process new information, stay healthy, and feel rested.

During sleep, your brain cycles through five stages: stage 1, 2, 3, 4, and rapid eye movement (REM) sleep. Different things happen during each stage. For example, you have a different pattern of brain waves during each one. Your breathing, heart, and temperature may be slower or faster in some stages. Certain phases of sleep help you :

• Feel rested and energetic the next day
• Learn information, get insight, and form memories
• Give your heart and vascular system a rest
• Release more growth hormone, which helps children grow. It also boosts muscle mass and the repair of cells and tissues in children and adults.
• Release sex hormones, which contributes to puberty and fertility
• Keep from getting sick or help you get better when you are sick, by creating more cytokines (hormones that help the immune system fight various infections)

You need all of the stages to get a healthy sleep.

The amount of sleep you need depends on several factors, including your age, lifestyle, health, and whether you have been getting enough sleep recently. The general recommendations for sleep are:

• Newborns: 16-18 hours a day
• Preschool-aged children: 11-12 hours a day
• School-aged children: At least 10 hours a day
• Teens: 9-10 hours a day
• Adults (including older adults): 7-8 hours a day

During puberty, teenagers' biological clocks shift, and they are more likely to go to bed later than younger children and adults, and they tend to want to sleep later in the morning. This delayed sleep-wake rhythm conflicts with the early-morning start times of many high schools and helps explain why most teenagers do not get enough sleep.

Some people think that adults need less sleep as they age. But there is no evidence to show that older adults can get by with less sleep than people who are younger. As people age, however, they often get less sleep or they tend to spend less time in the deep, restful stage of sleep. Older adults are also more easily awakened.

And 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 or cut short 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 you have trouble getting up in the morning?
• Do you have trouble focusing during the day?
• Do you doze off during the day?

If you answered yes to these three questions, you should work on improving your sleep.

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 affect your performance, including your ability to think clearly, react quickly, and form memories. This may cause you to make bad decisions and take more risks. People with sleep deprivation are more likely to get 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. Research shows that 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 mean that you don't get enough of the hormones that help children grow and help adults and children build muscle mass, fight infections, and repair cells.

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

You can take steps to improve your sleep habits. First, make sure that you allow yourself enough time to sleep. With enough sleep each night, you may find that you're 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 don't exercise too late in the day
• Avoid alcoholic drinks before bed
• Avoid large meals and beverages late at night
• Don't take a nap after 3 p.m.
• Relax before bed, for example by taking a bath, reading or listening to relaxing music
• Keep the temperature in your bedroom cool
• Get rid of distractions such as noises, bright lights, and a TV or computer in the bedroom. Also, don't be tempted to go on your phone or tablet just before bed.
• Get enough sunlight exposure during the day
• Don't lie in bed awake; if you can't sleep for 20 minutes, get up and do something relaxing
• See a doctor if you have continued trouble sleeping. You may have a sleep disorder, such as insomnia or sleep apnea. In some cases, your doctor may suggest trying over-the-counter or prescription sleep aid. In other cases, your doctor may want you to do a sleep study, to help diagnose the problem.

If you are a shift worker, it can be even harder to get a good sleep. You may also want to:

• Take naps and increase the amount of time available for sleep
• Keep the lights bright at work
• Limit shift changes so your body clock can adjust
• Limit caffeine use to the first part of your shift
• Remove sound and light distractions in your bedroom during daytime sleep (for example, use light-blocking curtains)