Not your ordinary midnight snack: Sleep eating disorders

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Midnight Snack Sean Murray 2008 CC BY-SA 2.0

Believe it or not, some people eat while they are asleep. They literally get up to prepare and consume food in the middle of measurable sleep stages during the night. There are also people who wake up needing to eat in order to fall asleep again.

We’re not talking about that late-night craving we sometimes get when we know there’s an extra piece of birthday cake calling from the kitchen.

Nor are we referring to snacking after we’ve done a long spate of studying or other work late into the night.

These are situations of compromised sleep hygiene. They have their own consequences and are not technically considered sleep disorders—just bad judgment calls.

And we’re not even describing the conscientious diabetic who may need a quick carbohydrate bite to balance insulin and glucose, or the nursing mom who grabs a cup of yogurt after the midnight feeding to replace her calcium.

No, sometimes the eating is automatic and happens only during clinical sleep or as part of an unhealthy sleep pattern.

Welcome to the world of sleep eating: Nocturnal Sleep Related Eating Disorders (NS-RED) and Night Eating Syndrome (NES).

Sleep eating disorders are real and serious

Our media tends to address these legitimate health problems either as amusing or freakish, but the fact is that they are serious, life-altering, even threatening, conditions that require diagnosis and treatment.

Sleep eating disorders are not the result of “poor willpower” or some other judgmental explanation. While they’re uncommon, they do exist and are considered part of the Rare Disease category.

Make no mistake: Sleep eating disorders can definitely make life hard for those suffering. For instance, uncontrolled weight gain in either NS-RED or NES can lead to anxiety and depression, as feelings of shame and powerlessness can be brought on by these unusual behaviors.

Are these sleep disorders or eating disorders?

There is some difference of opinion regarding whether either or both of these are categorized as parasomnias and/or eating disorders. However, both can wreak havoc not only on a person’s metabolic function but also on their sleep habits.

Perhaps the better question to ask is not which kind of disorder these can be labeled, but how to identify and treat these problems.

Nocturnal sleep-related eating disorder

Also known as “somnambulistic sleep eating,” NS-RED may take place during a spell of sleepwalking, which generally occurs as a kind of arousal between sleep stages.

Those who eat while asleep are not generally conscious of their behavior. Regular episodes of NS-RED can heighten the risk for developing diabetes. The body, due to circadian system demands, is not designed to manage caloric intake during sleep. The rise and fall of blood sugar during sleep can lead to problems with insulin resistance and other disorders of metabolism.

Night Eating Syndrome

People who suffer from NES have symptoms that persist for eight weeks or longer. They wake up lacking an appetite and tend to eat more of their total daily intake of calories AFTER dinner.

Some of those who suffer from NES may be practicing unhealthy dieting patterns during the day. An example might be low-calorie daytime dieting which leads to binge eating at night. Some of their issues may also be related to addiction issues. This is because the addicted brain may lack the necessary controls to stop unhealthy behavior.

What about Sleeping Beauty Disorder?

Binge eating may also be associated with a separate sleep disorder called Kleine-Levin Syndrome. This form of hypersomnia is more popularly known as “Sleeping Beauty” disorder. Sufferers encounter extended periods of irresistible sleepiness and participate in characteristic behaviors that can include overeating.

How to treat sleep eating disorders

Treatment of these disorders combines therapy for weight loss and addiction management with some environmental adjustments. This includes placing locks on cabinets and refrigerators for those who are unaware or not in control of their nocturnal sleep eating challenges.

Current pharmaceutical treatment with topimarole shows some promise for some nighttime sleep eaters. It’s also critical that doctors review a patient’s medications to rule out drug-induced behaviors.


Photo credit

“Midnight Snack” by Sean Murray, February 5, 2008, CC BY-SA 2.0.

This post previously appeared in a slightly different form at SleepyHeadCENTRAL in December 2014 and has been updated for use here.