Sleep-Related Eating Disorder

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

Commonly, people experiencing SRED will restrict calories during the daytime, and take in a large percentage of their calories at night. These calories are often from sugary, carbohydrate-rich foods. Sometimes inedible foods like soap, detergent or paper products are consumed.

Other symptoms of SRED include:

  • Rising to eat during the first half of the night
  • Eating in an out-of-control fashion (i.e. a binge)
  • Consuming large quantities of food in a clumsy, sloppy manner
  • Foggy, inaccurate or absent memory of the event later

Up to 5 percent of adults may have SRED, which affects more than twice as many women as men. It is estimated that 1.5 percent of adults have ongoing SRED.

The cause of SRED is unknown, but some research points to abnormalities in the hormones leptin and ghrelin hormones that control hunger.

Other factors linked to an increased risk of SRED include:

  • Anxiety or stress
  • Obesity
  • Mental health disorders, including depression
  • Eating disorders like bulimia or anorexia
  • Sleepwalking
  • Having a relative who sleepwalks or has SRED
  • Other sleep disorders like narcolepsy obstructive sleep apnea
  • Using a hypnotic sleep medication like zolpidem (Ambien)

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.

Treatment

While some parasomnias are considered more 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.

Sometimes, SRED appears to result from a “phase delay” or circadian rhythm abnormality. In these cases, light therapy can help shift the circadian rhythm, along with mealtimes, into a healthier pattern.

When behavioral and lifestyle modifications don’t help SRED, medications can help reduce or eliminate symptoms. These include dopamine agonists, opiates, trazodone, and topiramate.

Additional Resources