VISIONS OF SUGARPLUMS || Sleep Disorders 101: NS-RED and NES, Sleep Eating Disorders

"Sleep eating" image courtesy Dr Austin Ejaife.

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 and have to eat something or else they will not be able to fall asleep again.

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. They are not the result of "poor willpower" or some other judgmental explanation. Sleep eating disorders are uncommon, but they do exist. These abnormal eating patterns during the night can definitely make life hard for those suffering. Uncontrolled weight gain in either case can lead to anxiety and depression from the feelings of shame and powerlessness brought on by these unusual 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.

Nocturnal sleep-related eating disorder, also known as NS-RED or somnambulistic sleep eating, 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, as the body 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.

The other form of sleep-eating disorder is NES, or night eating syndrome. People who suffer from this have symptoms that can persistent 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. While some of those who suffer from NES may be practicing unhealthy dieting patterns during the day (low-calorie daytime dieting which leads to binge eating at night), some of their issues may also be related to addiction issues, in which the brain lacks the necessary controls to stop unhealthy behavior.

Treatment of these disorders combines therapy for weight loss and addiction management with some environmental adjustments, such as placing locks on cabinets and refrigerators for those who are unaware 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 if they suffer from either of these problems so as to rule out drug-induced behaviors.

Note also that binge eating may also be associated with a separate sleep disorder, a form of hypersomnia called Kleine-Levin Syndrome, more popularly known as "Sleeping Beauty" disorder, in which sufferers extended periods of irresistible sleepiness and participate in overeating and hypersexual behaviors.


Resources

"Classification of Sleep Disorders." Michael J. Thorpy. Neurotherapeutics. 2012 October; 9(4): 687–701. Published online 2012 September 14. doi: 10.1007/s13311-012-0145-6

"Sleep and Parasomnias." Dr. Carlos Schenck. National Sleep Foundation. 2014.

"Sleep-related Eating Disorder." Mayo Clinic. 2014

"Sleep-Related Eating Disorders." Cleveland Clinic. 2013