Learn about sleep-related eating disorder

Overview

Sleep-related eating disorder is frequent episodes of out-of-control eating and drinking behaviors while in a state of sleep. You are 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 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.

Symptoms of 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 of eating and drinking in an out-of-control manner, generally nightly
• 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 of eating and drinking
• Experiencing a negative impact on health from the nighttime eating

When do you need 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, you need to go to see a doctor.

Causes of sleep-related eating disorder

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 this disorder occurs is not known, but it often occurs in people who have a history of sleepwalking, so these conditions may be related.

Risk factors

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 relative — a parent, child or sibling — with sleep-related eating disorder or sleepwalking
• Experiencing sleep deprivation

Complications of sleep-related eating disorder

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

Diagnosis of sleep-related eating disorder

The diagnosis of sleep-related eating disorder may include:

• Physical exam. The 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, the 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. The 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.

Treatment of sleep-related eating disorder

Your treatment may include:

• Discontinuing medications that can be reason. You may need to stop or change current medications that may be contributing to 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 or not.

Care at home

In addition to the 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 smoking tobacco.

Preparing for an appointment with a doctor

If you’re having sleep problems, you may start by talking to your primary care doctor. Take your bed partner along with you. Your doctor may want to talk to your bed partner to learn more about your sleep experiences and to help determine whether other sleep disorders may exist, such as obstructive sleep apnea.

What you can do to prepare

Ask the doctor whether 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 symptom 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 dietary supplements that you’re taking and their dosages. Let the doctor know about anything you’ve taken to help you sleep.
• Questions to ask your doctor.

Basic questions to ask your doctor include:

• What is likely causing my symptoms?
• What’s the best treatment method?
• Should I go to a sleep clinic? Will my insurance cover it?

Don’t hesitate to ask other questions during your appointment.

What your doctor will ask

The doctor may ask you the following questions:

• Do you have evidence of eating during the night without memory of this event?
• Has this disorder impacted your health or weight?
• During an eating episode, what types of things do you eat?
• Have you been injured during an eating 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?