Sleep-Related Eating Disorder: What You Need to Know
Behaviors such as sleepwalking or sleep terrors are very common among children, and they generally subside with age. These are classified as non-rapid eye movement (NREM) sleep arousal disorders and are strongly linked to genetics. Adults rarely experience regular episodes of sleepwalking, but there is a whole other phenomenon that can occur in adult age, that connects sleep arousal disorders with eating disorders.
Sleep-related eating disorder (SRED) is a parasomnia that involves uncontrolled eating and drinking while in a state of sleep, during the NREM phase in the first half of the night. Similar to sleepwalking, the affected individual can be partially or completely unaware of their actions, is difficult to redirect or awaken from the episode, and will have no memory of the episode the next morning. However, because this disorder involves preparing and eating food unconsciously, it presents a greater threat to health and safety, and can result in depression.
It is not discussed as often as other eating disorders, so we will provide you with information on its causes, risks, and treatment, as well as what to do if you think you might be affected.
The exact cause of sleep-related eating disorder is not known, but there are some indicators that give us clues. It is closely associated with sleepwalking; so naturally, those with a history of sleepwalking or a hereditary predisposition to it are more likely to be affected. Other sleeping disorders or conditions that disrupt sleep and cause abrupt awakenings can also be a potential trigger.
About 1 to 3% of the general population is thought to be affected by SRED, and although it occurs among men as well, it is most common among women between 20 and 40 years of age. However, 10 to 15% of people with various daytime eating disorders are affected by SRED, and this gives us valuable insight to what might cause these night-time behaviours. This piece of information indicates that those who diet during the day (whether suffering from an actual disorder or just adhering to a strict weight-loss regime) are vulnerable to binge eating during sleep, when they lose control and their body goes after daytime cravings.
Hypnotic sleep medications, as well as some antidepressants and antipsychotics can also put individuals at an increased risk of developing sleep-related eating disorder.
As you can suspect, this disorder is dangerous because not only does it include nocturnal binge eating, but preparing the food as well. Individuals can harm themselves with kitchen utensils and appliances during this process, eat something they’re allergic to, eat something toxic or choke. Naturally, health complications are likely to arise from eating food you essentially didn’t choose, and weight gain is a common result. The nocturnal eating results in sluggishness in the morning, and those affected by the disorder who are aware of it but not looking for treatment, feel helpless and guilty over the lack of control.
That is why SRED needs to be brought to light just like any other disorder – with no shame and stigma around it. It has nothing to do with gluttony or control; it is a complicated parasomnia that requires treatment.
Initially, sleep-related eating disorder is treated with a strong focus on lifestyle change, closely monitored by professionals. This requires a close look at overall mental health, diet, level of physical activity, and sleeping habits.
Something that we must not overlook is the connection of SRED to daytime eating habits. Many patients are overweight and in their efforts to diet, they cut back on various food groups. Incidentally, a common symptom of SRED is eating odd combinations of foods and especially foods that are rich in carbohydrates. It cannot be stressed enough – the body requires a diverse, balanced diet for proper nutrient intake. Someone who is on a weight loss regime needs to include carbohydrates in their diet as much as all nutrients, whether it be through a controlled supplement intake or carefully planned, healthy meals. A proper eating regime will reduce cravings that might otherwise result in nocturnal binge eating.
Also, practising good sleep hygiene can be crucial to treating SRED, as well as preventing it from occurring in the first place. This is a strategy stressed by doctors in the process of treating the disorder. Generally, along with a balanced diet, the first step is treating other sleep disorders that might be present, such as sleepwalking or obstructive sleep apnea, as it can cause abrupt awakenings and disrupted sleep that can alter sleep phases and trigger SRED.
After diagnosis, doctors also recommend methods to reduce stress and anxiety, as this is often a trigger to both sleeping and eating disorders. These methods may include meditation, counselling, increased physical activity and limited intake of alcohol and caffeine.
Medications that could be potential triggers are assessed by doctors and discontinued or substituted accordingly. Lastly, if all these strategies don’t prove effective with time, doctors may recommend the appropriate medications, depending on the assessed cause of SRED for the individual and their medical condition.
If you think you might be affected by SRED
If there is any indication or suspicion that you might have nocturnal eating episodes, don’t hesitate to go to your doctor right away. The sooner you go, the better, as a huge burden will be taken off your back, not to mention reducing the risks of harm. It is not enough to have a partner or family member monitor you, because you’ll want a solution to your problem, not a band-aid for it each and every night.
You doctor will ask questions about your medical history and ask you sleep-related questions such as whether you’ve ever had sleepwalking episodes and the general patterns of your sleep. You might be required to keep a sleep diary for a couple of weeks and all information from your partner or family members will be helpful to determine your sleeping habits. Essentially, your first visit will revolve around these sets of questions, and don’t hesitate to ask any questions you might have yourself. To determine and properly diagnose you, your doctor will then recommend a video-recorded sleep study. This test, known as polysomnography, monitors and records body activities while you sleep: brain waves, body and eye movements, breathing and heartbeat rhythm. No part of diagnosis is painful or uncomfortable, so have no fear and put trust in your health care professional.
Sleep is such an overwhelmingly important process for us, but unfortunately, all kinds of sleeping disorders are common today as a result of our stressful environment. In our quest to shed light on mental health, sleep is a very important topic, as are the disorders related to it. If you think someone you know could be at risk of developing sleep-related eating disorder, don’t hesitate to talk to them about it and encourage them to get treatment – it could be a life-saver.