Eating in Your Sleep?

If you are still gaining weight despite all your attempts at diet and exercise, it may be due to secret nighttime nibbling caused by a peculiar, potentially dangerous sleep disorder.

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Imagine waking up to find a trail of cookie crumbs on the floor and empty food containers littering the kitchen counter and you had no idea how they got there. Either Hansel and Gretel broke into the house or someone is playing a practical joke on you.

Or, you have a bonafide sleep disorder that causes sufferers to eat voraciously while they sleep.

Up to 1 million adults could be sleep eaters, a possible contributing cause of obesity. In fact, a good percentage of patients who attend obesity clinics have been diagnosed with a sleep-eating condition.

The Bane of Bedtime Banquets

Researchers are beginning to discover factors that link appetite, sleep and body weight. And as bizarre as it may sound, conditions that cause sleep eating may the reason some people continue gain weight despite their best weight-loss efforts. Two seemingly related conditions may offer more clues to this weighty issue.

 

Sleep-Related Eating Disorder

Nighttime sleep-related eating disorder (SRED) is classified as parasomnia, a category of sleep disorders that cause a person to do unusual things during sleep such as sleepwalk (somnambulism), scream (night terrors) and wriggle about (periodic limb movement disorder).

People with SRED appear to be sleeping, but get up and make a beeline to the kitchen. Sufferers are undiscerning foragers. Beside the usual snacks, uncooked foods, toxic substances and inedible materials can also make the menu. Never mind that the steel wool pad tastes like, well, steel wool. Down the hatch it goes. And some unusual food (and non-food) combinations could make your stomach turn. But that is not the only downside. Because sleep eaters awaken a few times a night, they never experience a full night of uninterrupted sleep which can leave them feeling like they never slept at all. This could be severely impact next-day functioning.

Not only can it sabotage a well-balanced diet, sleep eating can up the risk for cuts and burns if chopping or cooking takes place. It can also be life threatening, especially for people with food allergies and diabetes, who must tightly monitor and gauge food intake for proper insulin management.

The condition is a quite a mystery and the cause elusive. Many people with SRED started out as sleepwalkers or have been diagnosed with another sleep disorder, which points to a defect in sleep centers as the root cause.

Sleep is an extremely complicated biological process influenced by hormones and intertwined feedback systems. When the mechanism that controls wakefulness and sleep during a normal sleep cycles fails, a person can remain "asleep" but continue to walk, eat, or perform other activities (some people get in their cars and drive!). And paradoxically, SRED can also be brought on by certain sleep medications, which some people take to help them fall and stay asleep.

Night-Eating Syndrome

Another nocturnal nuisance is night-eating syndrome (NES). This problem is a little different from SRED and may technically not be a sleep disorder, but an eating disorder instead. Many people with NES however have trouble falling or staying asleep, a symptom of insomnia, which is why the lines are blurred to its classification. Alternatively, NES and SRED may be part of the same syndrome, but different parts of the spectrum. Regardless, this problem can be equally detrimental to one's health.

NES sufferers may eat a normal dinner but between 8 pm and 6 am, it's a feeding frenzy. They usually recall the eating episodes but the urges are uncontrollable, strong and occur at frequent intervals of wakefulness. High-calorie carbohydrates are the food of choice. People with NES can consume up to 50% of their daily calories at night. They wake in the morning full and satiated and often skip breakfast.

Like SRED, nighttime-eating syndrome is poorly understood. People with certain forms of depression and substance abusers are at higher risk.

Advice for All-Night Diners

If you find evidence of nighttime snacking in the bed, on the counter, or on the scale, you may want to think about getting evaluated for sleep-eating syndromes. Padlocking and alarming pantries, refrigerators and knife drawers can help, but they aren't good long-term solutions. Since few doctors are knowledgeable about sleep-eating syndromes it may be best to find a sleep medicine specialist who can do proper sleep studies in order to diagnose a sleep condition.

Although there are no medications specifically designed for treating SRED or NES per se, many patients have found certain antidepressant and anticonvulsant drugs helpful. In many cases there will be a period of trial and error before the right medication or combination of medications are found.

Here are some action steps you can take in advance of meeting with your doctor. The answers can help make a diagnosis and guide treatment decisions.

  • Ask your bedmate (if you have one) if they notice anything unusual occurring while you sleep
  • Get a comprehensive medical exam to rule out any medical and mental health conditions
  • Keep a sleep diary and write down how often you get up to eat (if alert and awake)
  • Review all prescription, over-the-counter medications and dietary supplements to see if any could be affecting your sleep
  • Stop taking prescription sleep medications to see if that helps
  • Assess your sleep environment and sleep hygiene practices and make changes if necessary
  • Keep high-calorie, empty carbohydrates out of the pantry and refrigerator
  • Assess your level of hunger in the morning and note the time of your first meal
  • Calculate how many calories you eat before and after dinner to see what percentage is eaten at night
  • Find a doctor that will not dismiss your suspicions
  • Identify any triggers such as stress and implement stress reduction techniques to quell urges