Sleep-related eating disorder
Sleep-related eating disorder involves episodes of compulsive eating while sleepwalking during the night, with little or no memory of it in the morning.
Sleep-related eating disorder involves frequent episodes of out-of-control eating and drinking behaviors while in a state of sleep. You may be partially or fully unaware of your behavior while preparing and eating food, with little or no memory of these actions the next morning.
Sleep-related eating disorder can be dangerous because you could injure yourself during food preparation or eat inedible or toxic items. Sleep-related eating disorder can also have an impact on your health due to weight gain and obesity from eating high-carbohydrate and high-fat foods.
Sleep-related eating disorder can be associated with certain medications, eating disorders and other sleep disorders. Addressing these issues often resolves sleep-related eating disorder.
Sleep-related eating disorder is a parasomnia — abnormal activity or behavior that occurs while you're falling asleep, sleeping or waking up.
Episodes of sleep-related eating disorder occur in the first half of the night after you've been sleeping and include:
- Frequent episodes, generally nightly, of eating and drinking in an out-of-control manner
- Impaired consciousness while preparing and eating food
- Little or no memory of these actions the next morning
- Eating high-carbohydrate and high-fat foods or odd combinations of food
- Possibly eating inedible or toxic substances, such as frozen foods, coffee grounds, cleaning solutions or cigarette butts
- Possibly experiencing injuries or engaging in dangerous food preparation activities
- Not being easily awakened or redirected during the episode
- Experiencing a negative impact on your health from the nighttime eating
When to see a doctor
Sleep-related eating disorder can be dangerous and impact your health and safety. If you have any of the symptoms listed above, see your doctor.
Sleep-related eating disorder usually occurs during non-rapid eye movement sleep in the first half of the night and is associated with the transition from non-rapid eye movement to arousal during sleep.
The exact mechanism for why it occurs is not known, but sleep-related eating disorder often occurs in people who have a history of sleepwalking, so these conditions may be related.
Sleep-related eating disorder is more common in women and typically starts in the teenage years or the early 20s.
Increased risk of developing sleep-related eating disorder is associated with:
- Other sleep disorders, such as obstructive sleep apnea, sleepwalking, narcolepsy and restless legs syndrome
- Hypnotic sleep medications, such as zolpidem (Ambien, Edluar, Intermezzo, Zolpimist), and certain other medications, such as antidepressants or antipsychotics
- Having a daytime eating disorder, such as bulimia or anorexia
- Having a mental health disorder, such as stress, anxiety or depression
- Having a first-degree relative — a parent, child or sibling — with sleep-related eating disorder or sleepwalking
- Experiencing sleep deprivation
A sleep-related eating disorder can result in:
- Dangerous use of kitchen appliances, falls, cuts, burns, choking, injury from eating something inedible or toxic, or eating something you're allergic to
- Health problems, such as weight gain, poor diabetes control or dental cavities
- Feelings of guilt and helplessness over the lack of control
- Daytime tiredness from disrupted sleep
The diagnosis of sleep-related eating disorder may include:
- Physical exam. Your doctor asks questions about your medical history to rule out possible underlying causes of sleep-related eating disorder.
- Sleep habits review. In addition to asking you sleep-related questions, your doctor may have you complete a questionnaire to determine your sleep-wake pattern and level of daytime sleepiness. You may also be asked to keep a sleep diary for a couple of weeks. Information from your sleep partner, parent or other household members may be helpful.
- Sleep study. Your doctor will likely recommend a video-recorded sleep study called polysomnography. This test monitors and records a variety of body activities while you sleep, including brain waves, breathing, heartbeat, eye movements and body movements.
Your treatment may include:
- Discontinuing medications that can be triggers. This may involve stopping or changing current medications that may be contributing to your sleep-related eating disorder.
- Treating other sleep disorders. Sleep-related eating disorder may be reduced by treating other sleep disorders that are often associated with it, such as sleepwalking, restless legs syndrome or obstructive sleep apnea.
- Safety strategies. Your doctor may recommend strategies to ensure safety and offer education to your bed partner and household members on how to safely and gently coax you back to bed without using restraint or awakening you. Strategies may also include changes to your sleep routine.
- Medications. If other strategies haven't been successful, your doctor may recommend medications. The type of drug depends on the cause of your sleep-related eating disorder and whether you also have another type of eating or sleep disorder.
In addition to your treatment plan, lifestyle changes that may help include:
- Environmental changes. Make your sleep area and kitchen safer to avoid injury. Also, consider storing foods typically eaten during a sleep-related eating disorder episode outside the kitchen or placing locks on cabinets and the fridge.
- Good sleep habits. Develop regular sleep and wake times. Try to go to bed and get up at the same time each day, including weekends. Get enough sleep every night.
- Focus on staying healthy. For example, avoid alcohol and tobacco.
If you're having sleep problems, you may start by talking to your primary care doctor. Take your bed partner along, if possible. Your doctor may want to talk to your partner to learn more about your sleep experiences and to help determine if other sleep disorders may exist, such as obstructive sleep apnea.
What you can do
Ask your doctor if there's anything you need to do in advance, such as keep a sleep diary. Prepare for your appointment by making a list of:
- Any symptoms you're experiencing, including any that may seem unrelated to the reason for the appointment.
- Personal information, including new or ongoing health problems, major stresses, or recent life changes.
- All medications, including over-the-counter medications, vitamins, and herbal or other supplements that you're taking and their dosages. Let your doctor know about anything you've taken to help you sleep.
- Questions to ask your doctor to make the most of your appointment time.
Basic questions to ask your doctor may include:
- What is likely causing my symptoms?
- What's the best treatment?
- I have these other health conditions. How can I best manage them together?
- Should I go to a sleep clinic? Will my insurance cover it?
- Are there any brochures or other printed material that I can have?
- What websites do you recommend?
Don't hesitate to ask other questions during your appointment.
What to expect from your doctor
Your doctor may ask you several questions. Be ready to answer them to spend time on areas you want to focus on. Some questions your doctor may ask include:
- Do you have evidence of eating during the night without memory of the event?
- Has this impacted your health or weight?
- During an episode, what types of things do you eat?
- Have you been injured during an episode?
- What medications are you taking?
- Have you ever been diagnosed with a sleep disorder or an eating disorder?
- Have you experienced sleepwalking in the past?
- Have you experienced restless legs symptoms in the past?
- Have you been told of any breathing issues during your sleep, such as loud snoring, choking, gasping or breathing pauses?
May 5th, 2021