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Correct me if I'm wrong.
Issues can either be physical or psychological. Physical can be a natural defect, traumatic defect or production irregularity caused by external influence. Psychological causes can be singular traumatic events or periodical low-level accumulation of stress.
The course of discovery and treatment is narrowing down the possible causes and finding a solution for rehabilitation.
My presumption for sexsomnia is this:
Medicine is really biopsychosocial. Meaning, we're biological, psychological, and social beings, and often a cause isn't as cut and dry as it is in the traditional view of medicine. It's the chicken and the egg.
Is the body causing depression, is the mind, is the environment? Sometimes it's one of these factors, but often it's some combination or a combination of all three and often these factors can have feedback loops within them (my jobs sucks, so I drink which makes my job harder which makes it suck more, so I drink harder)
So really, things have to be looked at on multiple levels and in the above situation in particular, psychological treatment should always be part of a multimodal approach because of the psychosocial adjustment element at play and the stress it would cause on the organism (whole person, body and mind).