Sleep-related Eating Disorder
Sleep related eating disorder (SRED) is a parasomnia. A parasomnia involves undesired events that come along with sleep. SRED consists of repeated episodes of compulsive binge eating and drinking after waking up in the night.
Episodes always occur in an “out of control” manner. They tend to occur when you are only partially awake. You may have only a partial memory or no memory of the event afterward. Other people are very alert as they eat. They recall much of the episode in the morning. It may be very hard to wake you up during an episode of eating. Trying to stop a person during an episode tends to provoke anger and resistance.
A majority of people with SRED have an episode of eating nearly every night. Some eat more than once each night. These episodes tend to occur even though feelings of hunger and thirst are absent. The episodes can occur at any time in the night.
Foods that are high in calories tend to be eaten the most. It is common to eat or drink thick and sugary foods such as peanut butter or syrup. The foods eaten during sleep are usually not preferred during the day
The foods are consumed very rapidly. An entire episode may last for only ten minutes. This consists of the time it takes to get from bed to the kitchen and back to bed again.
Injuries may occur during an episode. Sloppy food handling often occurs. You may or may not prepare hot or cold foods properly. This can cause cuts and burns. Fires can also occur from careless cooking. Alcoholic drinks are almost never consumed. You may find a very messy kitchen in the morning. This may cause you to remember the episode.
SRED may develop slowly over time. It may also begin quickly with nightly episodes of eating from the start. It is long lasting and does not seem to ease up over time. It may be a factor in causing depression. This can result from a sense of shame and failure to control the eating. Some people with SRED may avoid eating during the day. They may also get too much exercise in an attempt to prevent obesity.
Problems resulting from SRED include the following:
- Eating strange forms or combinations of food, such as raw bacon, buttered cigarettes or coffee grounds
- Eating or drinking toxic substances, such as cleaning solutions
- Eating foods to which you are allergic
- Suffering from insomnia due to sleep disruption
- Sleep-related injury
- Loss of appetite in the morning
- Stomach pain
- High cholesterol
- Excessive weight gain and obesity
Who gets it?
It is not known how many people have SRED. Like other eating disorders, it is much more common in women than in men. Females represent about 65% to 80% of SRED patients. The average age when it first occurs is 22 to 29 years. It tends to be an ongoing and long-lasting problem.
SRED can develop on its own. It can also result from the use of certain medications. This is especially true of medications used to treat depression and sleep problems.
More than one sleep disorder may even be found in a person with SRED. More than half of all people with SRED had another parasomnia before SRED began. Sleepwalking is the most common sleep disorder related to SRED. Many people with SRED were sleepwalkers as children.
Other sleep disorders that can be closely linked to SRED include the following:
- Restless legs syndrome
- Periodic limb movement disorder
- Obstructive sleep apnea
- Irregular sleep-wake rhythm
- Sleep related dissociative disorders
Other factors that may lead to the development of SRED include the following:
- Use of certain medications
- Ending the habit of smoking
- Ending the abuse of alcohol or drugs
- Dieting during the day
- Daytime eating disorders
- Hepatitis (liver infection)
- Encephalitis (brain swelling)
How do I know if I have it?
- Do you have repeated episodes of “out-of-control” eating and drinking during the time when you sleep?
- Do one or more of the following result from your eating and drinking binges?
- You eat strange forms or combinations of food.
- You eat or drink inedible or toxic substances.
- Your eating episodes disturb your sleep, causing insomnia. As a result, your sleep is not refreshing or you are very tired during the day.
- You injure yourself.
- You do something dangerous while getting or cooking food.
- You have a loss of appetite in the morning.
- Your health declines from eating foods that are high in calories.
If you answered yes to these questions, then you might have sleep related eating disorder.
It is also important to know if there is something else that is causing your problem. It may be a result of one of the following:
- Another sleep disorder
- A medical condition
- Medication use
- A mental health disorder
- Substance abuse
Do I need to see a sleep specialist?
Yes. SRED can do more than just disturb your sleep. It can also harm your overall health and put you at risk of an injury.
What will the doctor need to know?
The doctor will need to know when the eating binges began. He or she will want to know how often they occur and how long they last. The doctor will need to know your complete medical history. Be sure to inform him or her of any past or present drug and medication use.
Also tell your doctor if you have ever had any other sleep disorder. Find out if you have any family members with sleep problems. It will also be helpful if you fill out a sleep diary for two weeks. The sleep diary will help the doctor see your sleeping patterns. This data gives the doctor clues about what is causing your problem and how to correct it.
Will I need to take any tests?
You may need to do an overnight sleep study. This is called a polysomnogram. The polysomnogram charts your brain waves, heart beat, and breathing as you sleep. It also records how your arms and legs move. The best sleep study will also record your sleep on video. This will record any unusual behaviors that occur during the night. This study will help reveal if your eating binges are related to any other sleep disorder,
How is it treated?
It is important to get plenty of sleep on a regular basis. Episodes may increase with sleep deprivation. To avoid injuries, you need to make sure that the path from your bedroom to the kitchen is safe.
Your doctor may need to change some of your medicines. A sleep specialist should check to see if you have another sleep disorder. If so, then you will also need to be treated for it. Doing so will make it easier to treat the SRED.
SRED tends to respond well to the use of medications. Once you begin taking the medicine, your doctor may have you chart your progress with a sleep diary.
SOURCE: American Academy of Sleep Medicine; Reviewed by David Kuhlmann, MD
Updated October 21, 2005