Sleep-Related Eating Disorders: Polysomnographic Correlates of a Heterogeneous Syndrome Distinct from Daytime Eating Disorders

Abstract

Over a 5-yr period, 19 adults presented to our sleep disorders center with histories of involuntary, nocturnal, sleep-related eating that usually occurred with other problematic nocturnal behaviors. Mean age (+/- SD) at presentation was 37.4 (+/- 9.1) yr (range 18-54); 73.7% of the patients (n = 14) were female. Mean age of sleep-related eating onset was 24.7 (+/- 12.9) yr (range 5-44). Eating occurred from sleep nightly in 57.9% (n = 11) of patients. Chief complaints included excessive weight gain, concerns about choking while eating or about starting fires from cooking and sleep disruption. Extensive polysomnographic studies, clinical evaluations and treatment outcome data identified three etiologic categories for the sleep-related eating: (a) sleepwalking (SW), 84.2% (n = 16); (b) periodic movements of sleep (PMS), 10.5% (n = 2) and (c) triazolam abuse (0.75 mg hs), 5.3% (n = 1). DSM-III Axis 1 psychiatric disorders (affective, anxiety) were present in 47.4% (n = 9) of the patients, and only two patients had a daytime eating disorder (anorexia nervosa), each in remission for 3-7 yr. Nearly half of all patients fulfilled established criteria for being overweight, based on the body mass index. Onset of sleep-related eating was linked directly to the onset of SW, PMS, triazolam abuse, nicotine abstinence, chronic autoimmune hepatitis, narcolepsy, encephalitis or acute stress. In the SW group, 72.7% (8/11) of patients had nocturnal eating and other SW behavior suppressed by clonazepam (n = 7) and/or bromocriptine (n = 2) treatment. Both patients with PMS likewise responded to treatment with combinations of carbidopa/L-dopa, codeine and clonazepam. Thus, sleep-related eating disorders can generally be controlled with treatment of the underlying sleep disorder.

Narcolepsy with Cataplexy Associated with Nocturnal Compulsive Behaviors: A Case-Control Study

“…1 SRED has been found associated with various sleep disorders in case series: sleepwalking (SW), periodic limb movements during sleep (PLMS), narcolepsy, restless legs syndrome (RLS), and obstructive sleep apnea (OSA). 6,7 The high rate of PLMS and rhythmic masticatory muscle activity in SRED patients, 8 together with the high prevalence of SRED (33%) in idiopathic RLS, 9 suggests a pathophysiological derangement of the dopaminergic system. Besides SRED, other compulsive behaviors can arise from nocturnal sleep, such as nocturnal smoking (NS).…”

The Relationship Between Daytime and Nighttime Food Intake in an Obese Night‐Eater

“…The polysomnographic recordings showed that D.L. 's eating episodes arose from stage 2 sleep which may differ from eating episodes that arise from,delta sleep and which have been associated with somnambulism (28). D.L.…”

“…Oswald and Adam (25) described night-eating episodes in a normal-weight male which were correlated with periods of rapid eye movement (REM) sleep. Schenck et d. (28) reported on 19 adults who presented to a sleep disorders center with histories of involuntary nocturnal sleep-related eating. In this group, most of the sleep-related eating disorders were controlled by treating the underlying sleep disorder with pharmacological agents.…”

Prevalence of eating disorders and eating attacks in narcolepsy

“…Thus it can not be ruled out that eating disorders or eating anomalies might manifest at some point in the life of narcoleptic patients, eg, at the time of onset and then ameliorate or disappear. In addition, the (parasomnic) sleep related eating disorder (Schenck et al 1991) and the night eating syndrome are not covered by the SIAB, so that the potential contribution to increased BMIs of these disorders could not be evaluated. Both traits are not known to be necessarily associated with obesity or increased BMIs in general (Schenck et al 1993;Striegel-Moore et al 2006) but may play a role in subsets of obese persons or under specifi c circumstances such as in narcolepsy.…”