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Sleep-Related Eating Disorder

What is Sleep-Related Eating Disorder?

Sleep-related eating disorder (SRED) is a parasomnia characterized by recurrent episodes of consuming food — often high-calorie junk food or inedible substances — during sleep. Confusion, disorientation, and inaccurate or absent memories of the event are components of SRED. The disorder combines aspects of sleepwalking with a binge-eating disorder.

The classic presentation of SRED is someone who rises in the first half of the night to eat and drink without being aware of what they are doing. This often happens regularly, even nightly in some cases. Like a sleepwalker, a SRED sufferer will have little awareness of what they are doing, and will have little to no memories of their actions.

Some SRED sufferers eat high-fat or high-calorie foods, while others eat unusual foods (like still-frozen food and raw meat) or inedible substances (such as cigarette butts or cleaning supplies).

Other potential symptoms include:

  • Lack of hunger in the morning
  • An inability to be woken or redirected during an SRED episode
  • Injuries due to eating dangerous materials or while preparing food
  • Weight gain or other negative health effects

SRED is separate from night eating syndrome (NES), another nocturnal eating disorder. People who suffer from NES are aware of their disordered eating, and it occurs before the onset of sleep.

Up to 5 percent of adults may have SRED, which affects more than twice as many women as men. People who suffer from another type of eating disorder are also significantly more likely to have symptoms of SRED.

What Causes Sleep-Related Eating Disorder?

There are few studies on the reasons for SRED. However, there is evidence for two potential causes:

Regardless of the underlying causes of SRED, we have a clearer idea of the factors linked to an increased risk for the disorder. These include:

  • Other sleep disorders, particularly RLS or parasomnias
  • The use of psychotropic medication
  • A lifetime diagnosis of other eating disorders
  • A family history of parasomnias, including SRED
  • Anxiety or stress
  • Quitting cigarette smoking
  • Sobriety from alcohol or stimulant drugs

Diagnosis

Because SRED may be linked to other health conditions, sleep disorders and medications, your health history and sleep patterns are important in the diagnosis of SRED. There is no single test for this condition. Your doctor will perform a medical examination and take your symptoms and sleep patterns into account.

You may be asked to keep a sleep diary to record sleep patterns, and your bed partner may be asked about your nighttime behavior, which you may not recall. An overnight sleep study, or polysomnogram, may be used to determine whether you have an underlying condition like obstructive sleep apnea. In some cases, a video may be recorded to confirm the presence of SRED behaviors.

Treatment

While some parasomnias are considered benign, SRED is one of the more dangerous sleep disorders. That’s because people with SRED may experience cuts and burns while preparing food, and may have negative health impacts as a result of nighttime eating. For these reasons, your doctor will work closely with you to determine an effective treatment plan for SRED.

Your treatment may include discontinuing sleep aids like Ambien, treating underlying sleep disorders, and addressing anxiety. In cases where SRED is the direct result of psychotropic medication use, discontinuing the medication (or adjusting dosage) may be the primary treatment for the disorder.

In addition to these treatments, some medications can help reduce or eliminate symptoms. For example, topiramate has been shown to significantly reduce SRED behaviors, as well as symptoms such as weight gain. However, not all patients are able to tolerate this medication.

Other medications which have shown potential benefits in treating SRED include clonazepam, opiates, dopaminergic agents, and combinations of different drugs. However, the research on some of these options is still in the earliest stages.

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