Nocturnal sleep-related eating disorder

Nellie Nguyen. 8/23/2020

Imagine waking up in the morning with your mouth covered in chocolate, surrounded by empty candy wrappers, but having no memory about how they got there. You become even more confused when a person you’re living with asks you why you were up at night eating chocolate. For people suffering from nocturnal sleep-related eating disorder (NSRED), this is a common experience.

According to Mayo Clinic , NSRED is a parasomnia that involves out-of-control eating and/or drinking behaviors during sleep. Parasomnia is a category of sleep disorders that usually causes unusual movement or behavior during sleep. Despite the name and symptoms, it is not necessarily considered an eating disorder, and it is normally categorized as a sleep disorder. Usually, the person suffering from this disorder may be somewhat or fully unaware of his or her behavior, and they will not remember their actions the following morning. These episodes of eating or drinking generally occur during the transition between non-rapid eye movement (NREM) sleep and REM sleep. However, it has been said that these episodes can also occur during different stages of sleep, whether the person is in the early stages of sleep or nearly about to wake up.

There are multiple dangers and health concerns for those with NSRED. For instance, they could potentially use dangerous kitchen appliances while preparing food, such as a knife or a stove. With an impaired consciousness, the person has less control over their actions and is more likely to harm themselves. Along with this, one could consume toxic substances or something that he or she is allergic to. There have been reports that people may even prepare bizarre combinations of food, like uncooked bacon smeared with mayonnaise. A more long-term risk involves the consumption of high-fat and high-sugar foods, which are common types of food that people consume during these episodes. Although there are usually no immediate effects, a person’s health may deteriorate over time as he or she consumes an unhealthy amount of these foods. Not only are there negative physical effects, but the disorder could also lead to numerous mental health complications too, such as anxiety and depression.

The thought of going to sleep knowing that you could eat something terrible or do something dangerous is alarming, but luckily, this disorder is uncommon. According to the National Center for Biotechnology, a study estimated that only about 5% of the general population suffers from NSRED. However, there are some conditions that can increase one’s likelihood of experiencing the disorder, such as already having a daytime eating disorder like bulimia or anorexia. In fact, the same study found that about 9-17% of those with eating disorders also have NSRED. Other risk factors include having a pre-existing mental health or sleep disorder, experiencing sleep deprivation, using a hypnotic sleep medication like zolpidem and having a first-degree relative with the disorder.

Thankfully, those with this disorder can receive treatment. The process usually starts with a clinical interview and then the person spends a night at a sleep-disorder center where his or her brain activity is monitored. From there, the person’s form of treatment can be determined. For some, medication can help, but it is advised to avoid taking sleeping pills as they may increase confusion or clumsiness and worsen the disorder. For the most part, ways to reduce stress and anxiety (such as stress management classes and counseling) would greatly benefit the person.

Despite the fact that only a small fraction of the population has NSRED, it can be beneficial to be more educated on the subject. People with this disorder normally feel confused, hopeless even, and they could feel alienated from the rest of society because of how uncommon the disorder is. Others being aware of their disorder and understanding what they are going through could be a huge step in providing them with much needed emotional support.