Sleep-Related eating disorder

Sleep Eating Disorder - Sleep Education by AASM

Sleep Eating DisorderKatherine Robards2021-05-06T15:10:02+00:00

September 2020 | Reviewed by: John Saito, MD and Virginia Skiba, MD

What is sleep eating disorder?

Sleep-related eating disorder (SRED) is a sleep disorder characterized by unusual eating behaviors during sleep. If you have this disorder, you sleepwalk and sleep eat without remembering the event afterward.

Most people with SRED have an episode of eating nearly every night. Sleep eating can occur at any time in the night. You may have more than one sleep-eating event per night. These episodes tend to occur even though you aren’t hungry or thirsty.

People with SRED tend to prefer thick, sugary, and high calorie foods such as peanut butter or syrup. The foods you eat during sleep-related events may be ones you don’t normally enjoy. Alcoholic drinks are rarely consumed.

During a sleep-related eating event, you eat food very quickly. An entire episode may last for only ten minutes. This includes the time it takes to get from your bed to the kitchen and back to bed again.

You will often sloppily handle food during these events. You may or may not prepare hot or cold foods properly. You may get injured during an episode from handling knives and utensils. You may also start a fire or get burns from careless cooking.

SRED may develop slowly over time. It may also begin quickly with nightly episodes of eating from the start. It is long-lasting and does not seem to ease up over time. It may be a factor in causing depression. This can result from a sense of shame and failure to control the eating. Some people with SRED may avoid eating during the day. They may also get too much exercise in an attempt to prevent obesity.

Problems resulting from SRED include the following:

Eating strange forms or combinations of food, such as raw bacon, buttered cigarettes or coffee grounds
Eating or drinking toxic substances, such as cleaning solutions
Eating foods to which you are allergic
Insomnia due to sleep disruption
Sleep-related injury
Loss of appetite in the morning
Stomach pain
High cholesterol
Excessive weight gain and obesity
Worsened control of diabetes

What are symptoms of sleep eating disorder?

Sleep-related eating disorder is defined by repeated episodes where you rapidly binge eat and drink during the night. These episodes are out of control and tend to occur when you are only partially awake. You may only have a slight memory or no memory of the binge. This may occur nightly. The food is often highly caloric and consumed in strange combinations. People with sleep-related eating disorders might accidentally injure themselves by eating toxic substances, burning themselves or causing fires.

People with sleep eating disorder often:

Have repeated episodes of “out-of-control” eating and drinking when you sleep
Eat strange forms or combinations of food
Eat or drink inedible or toxic substances
Have eating episodes that disturb your sleep, causing insomnia. As a result, your sleep is not refreshing or you are very tired during the day
Injure yourself
Do something dangerous while getting or cooking food
Have a loss of appetite in the morning
Have your health decline from eating foods that are high in calories

It is also important to know if there is something else that is causing your problem. It may be a result of one of the following:

Another sleep disorder
A medical condition
Medication use
A mental health disorder
Substance abuse

What are risk factors for sleep eating disorder?

It is not known how many people have SRED. Like other eating disorders, it is much more common in women than in men. Women represent about 65% to 80% of patients with SRED. The average age when it first occurs is 22 to 29 years. It tends to be an ongoing and long-lasting problem.

SRED can develop on its own. It can also result from the use of certain medications. This is especially true of medications used to treat depression and sleep problems.

More than one sleep disorder may even be found in a person with SRED. More than half of all people with SRED had another parasomnia before SRED began. Sleepwalking is the most common sleep disorder related to SRED. Many people with SRED were sleepwalkers as children.

Other sleep disorders that can be closely linked to SRED include:

Restless legs syndrome
Periodic limb movement disorder
Sleep apnea
Irregular sleep-wake rhythm
Sleep-related dissociative disorders

Other factors that may lead to the development of SRED include the following:

Use of certain medications
Ending the habit of smoking
Ending the abuse of alcohol or drugs
Stress
Dieting during the day
Daytime eating disorders
Narcolepsy
Hepatitis (liver infection)
Encephalitis (brain swelling)

How to diagnose sleep eating disorder?

SRED can do more than just disturb your sleep. It can also harm your overall health and put you at risk of an injury. If you have SRED, you should see a sleep doctor.

The doctor will need to know when the eating binges began. She will want to know how often they occur and how long they last. The doctor will need to know your complete medical history. Be sure to inform her of any past or present drug and medication use.

Also, tell your doctor if you have ever had any other sleep disorder. Find out if you have any family members with sleep problems. It will also be helpful if you fill out a sleep diary for two weeks. The sleep diary will help the doctor see your sleeping patterns. This data gives the doctor clues about what is causing your problem and how to correct it.

You may need to do a sleep study. This is called polysomnography. The test charts your brain waves, heartrate, and breathing as you sleep. It also records how your arms and legs move. The best sleep study will also record your sleep on video. This will record any unusual behaviors that occur during the night. This study will help reveal if your eating binges are related to any other sleep disorder.

How to treat sleep eating disorder?

Safety measures need to be addressed first. Some safety precautions include putting locks on your kitchen doors and cabinets and securely storing knives. Make sure that the path from your bedroom to the kitchen is safe.

It is important to get plenty of sleep regularly. Episodes may increase with sleep deprivation.

Your doctor may need to change some of your medications especially if you are taking certain sleeping medications. A sleep doctor should check to see if you have another sleep disorder, like sleep apnea. If so, you will also need to be treated for it. Doing so will make it easier to treat the SRED.

SRED tends to respond well to the use of medications. Once you begin taking the medicine, your doctor may have you chart your progress with a sleep diary.

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Sleep-Related Eating Disorder (SRED) — Pulmonary Associates of Brandon

You probably won’t find a person who’s never been caught eating late at night, especially if the fridge is full of scrumptious food and kind of beckons you to check it out. However, if you are regularly binge-eating at night and can’t fully control your nighttime routine, it’s time to seek professional help. Many people don’t know this, but the urge to binge-eat at night may signal a sleep-related eating disorder (SRED) that can be very dangerous for your overall health. Never heard of a sleep-related eating disorder? Don’t feel bad, most people haven’t. Here are the ins and outs:

What Is A Sleep-Related Eating Disorder (SRED)?

Sleep-related eating disorder is classified as parasomnia and is characterized by abnormal eating habits during the night time. Unlike nocturnal eating syndrome (NES), sleep-related eating disorder mostly affects people when they are partially or fully asleep and can’t control their actions.

During a sleep-related eating disorder attack, people can consume abnormal combinations of foods in substantially large amounts. On top of that, a person suffering from a sleep-related eating disorder will only partially remember that they were eating something at night.

Sometimes it may be challenging to wake up a person during an episode of SRED; instead, there’re high chances to arouse aggression and resistance.

Who Is At A Higher Risk For Sleep-Related Eating Disorder (SRED)?

While both males and females can suffer from SRED, women are often at higher risk, with 70% of all sufferers being female.

Additionally, people who suffer from any eating disorders like bulimia or purging disorder are just as exposed to the risk of getting a sleep-related eating disorder as other sleep disorder sufferers. For example, around half of SRED sufferers have had at least one other type of sleep disorder prior to obtaining a sleep-related eating disorder. Most often people who are exposed to sleepwalking, another type of parasomnias, have the highest chances to obtain SRED in the future.

Finally, some types of medications like hypnotic sleep medications, antidepressants, or antipsychotics may significantly increase the risk of developing a sleep-related eating disorder.

Complications That May Arise From Sleep-Related Eating Disorder

If your sleep-related eating disorder occurs frequently enough, it can cause a number of unpleasant—and even dangerous—conditions. Some examples of the most common are:

Sleep-related injury
Stomach pain
Food poisoning
Weight gain
Increased risk of Type 2 Diabetes
Daytime tiredness from poor sleep

Symptoms Of Sleep-Related Eating Disorder

All sleep-related eating disorder attacks occur at earlier stages of your sleep cycle and can include:

Nighttime eating and drinking out of control
Partial or no memory of the episode the next day
Trouble being awakened during SRED episodes
Injuries during SRED episodes
Eating bizarre food combinations that a person’s body is not used to

How Are Sleep-Related Eating Disorders Treated?

After an initial interview with your doctor, who will ask detailed questions about your daily and nightly routine, you’ll probably be invited to stay one or more nights at a sleep center in order to monitor your brain activity at night. Once your brain activity is measured and analyzed, your sleep doctor will find an appropriate treatment aimed at addressing the factors that trigger your sleep-related eating disorder. For example, if you suffer from another food-related disorder, your treatment will include a therapy towards both disorders, which will help mitigate the effects of each.

30 symptoms of an eating disorder

March 15, 2019 Health

According to the National Eating Disorders Association in the United States, up to 30 million people suffer from eating disorders.

What is an eating disorder

An eating disorder (EDD) is an unhealthy relationship with food. Patients eat too much or too little, are obsessed with the figure and cannot adequately perceive their body: at any weight it seems fat to them. nine0003

According to statistics, in the US alone, 20 million women and 10 million men suffer from eating disorders.

It is difficult to name the exact causes of eating disorders, but most often it is a psychological trauma or a genetic predisposition. The disorder can also arise due to pressure from society. An example is the work of models and athletes. They need to constantly monitor their form, otherwise they will not meet professional standards. Over time, this can turn into an obsession. nine0003

Disorders are divided into three main types:

Anorexia nervosa. During illness, a person is obsessed with thinness. Therefore, he eats little, trains a lot and tries to lose weight by any means.
Bulimia. The patient loses control and eats large meals, and then induces vomiting, takes laxatives, or exercises to exhaustion. The last form of the disease is called sports bulimia.
Compulsive overeating. A person also does not control himself while eating - he overeats until his stomach hurts, and after that he feels guilty. But unlike bulimia, it doesn't try to clear the stomach or burn calories immediately. nine0018

If you suspect you have an eating disorder but your symptoms are different, you may still have a problem. Do not ignore signs that seem strange or abnormal to you, see a doctor.

Who is at risk

Anyone can get an eating disorder. But most often RPP appears in women, especially in girls aged 13–18, athletes (gymnastics, figure skating, running), ballerinas.

How to recognize the signs of an eating disorder

Anorexia, bulimia and compulsive eating have different symptoms, but some of them overlap. If you notice at least a couple of signs of eating disorders in yourself, it is worth visiting a psychologist to stop the development of the disease.

10 signs of anorexia

Many people think that anorexia is excessive thinness. But this is not entirely true. Anorexia is a mental illness and does not depend on a person's weight. It is impossible to determine the disease only by appearance, it is necessary to take into account the emotional state and behavior. nine0003

Weight loss can also be caused by other diseases - clinical depression, digestive infection, intestinal inflammation, alcoholism, stomach ulcers.

If you notice the following signs in yourself, you need the help of a psychologist.

You constantly feel fat, worthless and ugly, but you are sure that a thin body will change this. However, no matter how much weight you lose, this feeling does not leave you. Over time, this leads to suicidal thoughts.
During the day, you often think about food, calories and exercise. Perhaps these thoughts do not leave you even in a dream. nine0018
You are very afraid of gaining weight.
You weigh yourself every day, and your mood depends on the number on the scale.
You restrict yourself in food, keep to a diet, excluded high-calorie foods from the diet.
Having to eat in public frightens and depresses you.
You try your best to burn calories by exercising hard and walking a lot.
If you are a woman, you may be having problems with your period.
You have strange eating rituals. For example, before you eat a salad, you separate it into ingredients. Or you chew each piece of food very carefully and for a long time. nine0018
You cannot objectively assess your figure. Consider yourself fat, even if everyone around you says that you are emaciated.

10 Signs of Bulimia

Every cell in our body depends on nutrition. Bulimia disrupts metabolism and leads to a deficiency of nutrients in the body. Therefore, the consequences can be very different.

If left untreated, bulimia can become chronic and lead to seizures, arrhythmias, bone weakness and fragility, esophageal ruptures, and kidney failure. nine0003

These signs will help you identify the problem:

You vomit after eating, take laxatives or diuretics.
You work off what you eat by training to the point of exhaustion.
Weight fluctuates constantly due to the large amount of food you eat.
The blood vessels in the eyes often burst. This is due to a lack of nutrients in the body. And in the case of sports bulimia - due to excessive physical exertion. nine0018
You can't stop eating when you're eating, even when you no longer feel physically hungry.
You prefer to eat alone so that no one will stop you from vomiting.
Your relationships with friends and family have deteriorated. Instead of spending time with them, you overeat and purge.
After eating, you feel guilty and disappointed.
You have stomach pains.
Teeth crumble and rot because tooth enamel has thinned due to gastric juice that comes out with vomiting. nine0018

Bulimia can only be diagnosed after a medical examination. To exclude other diseases, you need to take blood and urine tests.

10 Signs of Binge Eating

People with this disorder are usually overweight. They try to lose weight, but they break down and gain the lost kilograms back, which makes them feel lazy and weak-willed. Often patients do not even suspect that their problem is much more serious than a lack of purposefulness. nine0003

Symptoms to watch out for:

You eat a lot of food in a short amount of time because you can't control your appetite.
You take food very quickly, sometimes you do not have time to chew it properly.
You feel guilty, but you still overeat.
You are embarrassed by the fact that you eat a lot, so you do it in secret.
You have a mania for hoarding food and hiding it from others. nine0018
By eating in this mode, you are trying to compensate for low self-esteem, anxiety, and stress. But it always turns out the opposite: the more you eat, the worse you feel.
Eating boundaries are blurred - you can eat all day long.
Stomach problems appeared - pain, cramps, constipation.
You are trying to limit your food intake. Go on a diet, refuse some foods, but every attempt to lose weight ends in failure.
You have made meals a cult. Specially set aside time for an attack of overeating, doing peculiar rituals. For example, you serve dishes with special care, separate food by color. nine0018

If you notice symptoms of eating disorders not in yourself, but in a loved one, gently offer your help. Perhaps he wants to visit a psychologist, but is afraid or doubtful. Tell him about the need for a medical examination. If necessary, offer to go together. But in no case do not put pressure on the patient. Any careless word can harm him and force him to withdraw into himself.

Eating problems

Eating behavior is the totality of our eating habits - our taste preferences, eating habits, diet, etc. Eating behavior depends on many factors - cultural, ethnic, family traditions and values, the characteristics of the upbringing and behavior of family members and the biological characteristics of the body, the standards and standards of norm and beauty that have developed in this society. These habits can change—and often do over time—but not all of these changes will be considered a painful eating disorder. The most obvious unhealthy eating behaviors include anorexia nervosa and bulimia .

Anorexia nervosa (lat. anorexia neurosa) (from other Greek ἀν- - “without-”, “non-” and ὄρεξις - “urge to eat, appetite”) - eating disorder , characterized by deliberate weight loss, caused and / or supported by the patient, in order to lose weight or to prevent weight gain. In anorexia, there is a pathological desire to lose weight, accompanied by a strong fear of obesity. The patient has a distorted perception of their physical form and there is a concern about weight gain, even if this is not actually observed. The overall prevalence of anorexia nervosa is 1.2% among women and 0.29% among men. About 90% of patients with anorexia are girls aged 12-24 years. The remaining 10% includes men and women of more mature age up to menopause.

The causes of anorexia and bulimia are divided into biological, psychological (family influence and internal conflicts), and social (environmental influence: expectations, standards and standards of beauty, social stereotypes, diets). Biological factors - overweight and early onset of the first menstruation. In addition, the cause of the disease may lie in the dysfunction of neurotransmitters regulating eating behavior, such as serotonin, dopamine, norepinephrine. nine0141 Family factors - more likely to develop an eating disorder in those who have relatives or loved ones suffering from anorexia nervosa, bulimia nervosa or obesity. Having a family member or relative with depression, alcohol or drug abuse or addiction, also increases the risk of an eating disorder. Personality factors - Psychological risk factors include perfectionism and obsessive personality, especially for the restrictive type of anorexia nervosa. Low self-esteem and frustration tolerance, feelings of inferiority, insecurity and inadequacy are risk factors. nine0141 Cultural factors - these include: living in an industrialized country and an emphasis on harmony (thinness) as an important and significant sign of female beauty. Stressful events, such as the death of a close relative or friend, or sexual or physical abuse, can also be risk factors for developing an eating disorder. The self-esteem of an anorexic patient depends on the figure and weight, and the weight is not assessed objectively, the perception of the norm is reduced inadequately. Losing weight is regarded as an achievement, weight gain is regarded as insufficient self-control. Such views persist even in the last stage (“my height is 170, weight 39kilogram, I want to weigh 30”).

Stages of anorexia

Dysmorphomanic - thoughts about one's own inferiority and inferiority prevail, due to imaginary fullness. Characterized by a depressed mood, anxiety, prolonged examination of oneself in the mirror. During this period, there are the first attempts to limit oneself in food, the search for the ideal diet.
Anorectic - occurs against the background of persistent starvation. A weight loss of 20-30% is achieved, which is accompanied by euphoria and a tightening of the diet, "to lose even more weight." At the same time, the patient actively convinces himself and those around him that he has no appetite and exhausts himself with great physical exertion. Due to a distorted perception of his body, the patient underestimates the degree of weight loss. The volume of fluid circulating in the body decreases, which causes hypotension and bradycardia. This condition can be accompanied by chilliness, dry skin, and even alopecia (baldness). Another clinical sign is the cessation of the menstrual cycle in women and a decrease in libido and spermatogenesis in men. Adrenal function is also impaired, up to adrenal insufficiency. Due to the active decay of tissues, appetite is additionally suppressed by intoxication of the body. nine0018
Cachectic — period of irreversible dystrophy of internal organs. Comes in 1.5-2 years. During this period, weight loss reaches 50 percent or more of its mass. In this case, protein-free edema occurs, the water-electrolyte balance is disturbed, and the level of potassium in the body sharply decreases. This step is usually irreversible. Dystrophic changes lead to irreversible inhibition of the functions of all systems and organs and death.

Bulimia nervosa (from other Greek βοῦς, bus - "bull" and other Greek λῑμός, limos - "hunger") (literally bullish hunger, kinorexia) - an eating disorder characterized by a sharp increase in appetite (wolfish appetite), usually coming in the form of an attack and accompanied by a feeling of excruciating hunger, general weakness, sometimes pain in the epigastric region. This violation of eating behavior is manifested mainly by recurring bouts of gluttony, food "spree". To avoid obesity, most patients with bulimia at the end of the "revelry" resort to one or another method of cleansing the stomach and intestines, artificially inducing vomiting in themselves or taking laxatives and diuretics. Others use excessive exercise or intermittent fasting. Like those with anorexia nervosa, most bulimics are young women, usually in their late teens and early 30s. Bulimics often look normal and healthy on the outside, but are usually overly demanding of themselves and others, prone to loneliness and depression. They tend to raise standards and lower self-esteem. Their life is almost entirely focused on food, their own figure and the need to hide their "mania" from others. Even when working or attending school, they usually shun society. Bulimia can be indicated by depression, poor sleep, talk of suicide, excessive fear of gaining weight, and frantic grocery shopping. Typically, bulimics have "bouts" about 11 times a week, but the frequency of such attacks varies from 1-2 per week to 4-5 per day. nine0141 Bulimia can have severe health consequences. Frequent vomiting causes irritation of the pharynx and esophagus, as well as destruction of tooth enamel by acid from the stomach. Sometimes there is a cessation of menstruation. The most serious effects are associated with dehydration and loss of electrolytes (sodium and potassium) due to vomiting and diarrhea caused by laxatives.

The treatment of anorexia and bulimia requires the combined efforts of doctors from different specialties. Integral components of treatment are alimentary rehabilitation and measures aimed at restoring body weight. nine0141 Nutritional rehabilitation programs typically use emotional care and support, as well as a variety of behavioral psychotherapy techniques that involve a combination of reinforcing stimuli that integrates exercise, a strict exercise regimen and rest, in addition, prioritization of target body weight, desirable behaviors and informative feedback. The nutritional management of patients with anorexia nervosa is an important part of their treatment. nine0142 In chronic starvation, the need for energy is reduced. Therefore, weight gain can be promoted by initially providing a relatively low caloric intake and then gradually increasing it. There are several schemes for increasing nutrition, the observance of which guarantees the absence of side effects and complications in the form of edema, impaired mineral metabolism, and damage to the digestive organs. Supportive psychotropic drugs are often used in the treatment of anorexia and bulimia, in particular antidepressants and atypical antipsychotics . Plays an important role, individual psychotherapy ; it should be carried out by a specialist who inspires confidence in the patient. We all come from childhood. In people with eating problems, the upbringing and family situation is often quite typical. Lack of parental attention and approval, or a “contrast shower” due to sudden changes in parental mood, love and affection, forms a “complex” and attitude in the child: I must earn love! Serving her, the child becomes a perfectionist, demanding first of all to himself: everything must be perfect, from grades at school to appearance, figures . .. Often parents believe that instead of praise it is better to spur their daughter to success by comparisons. "Katya studies better! And Masha is so neat!" the child hears. Mothers, speaking in this way, believe that they come from the best of intentions and will benefit their child by this, they want to give an incentive for great accomplishments and improvement of their child. So, with mother's milk, the stereotype is sown that one should strive to be the first, the very best. The most interesting, smart, beautiful! The most neat, elegant and well-dressed! Unable to distinguish between emotional hunger and physiological hunger, a person easily switches from psychological problems to bodily ones, jams experiences in the literal and figurative sense of the word. Instead of friends, rest and entertainment - the first, second, third and compote. The lack of human communication, love and support is filled with cakes, pastries, favorite dishes and just what turns up under a hot hand and an irritated stomach. Family and friends usually do not understand the essence of the problem and experiences of a person with an eating disorder. They say: "Pull yourself together! Eat like all normal people!". This does not give the desired effect. Moreover, it drives a person with a problem of eating behavior even more into a psychological impasse and nervous tension. Great successes in the treatment of eating disorders are demonstrated by cognitive-behavioral psychotherapy and family therapy. Pharmacotherapy is at best an adjunct to other types of psychotherapy. Psychotherapy is aimed at correcting distorted cognitive formations in the form of perceiving oneself as fat, determining one's own value solely depending on the image of one's own body and a deep sense of inefficiency and inferiority. One of the elements of cognitive therapy is cognitive restructuring . In this approach, patients must find specific negative thoughts, list the evidence for those thoughts and list the evidence that refutes those thoughts, draw a valid conclusion, and use it to guide their own behavior.

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