By Emma Nolan
Photo courtesy of Wikipedia.
Imagine waking up in the morning with a pain in your stomach from eating too much the night before. Your bed is covered in crumbs and empty wrappers and the kitchen is a mess, yet you have no recollection of this binge eating episode.
For the many who subconsciously wander into their kitchens in the middle of the night while still asleep, these warning signs are no laughing matter. They indicate symptoms of a compendium of sleep and eating disorders, known in science as Night Eating Syndrome, and impinges greatly on the lives of those who suffer from it.
The obvious health and social problems incurred by ‘sleep eaters’ include weight gain, food poisoning from ingesting raw or uncooked food, or even totally inedible substances. Other injuries are incurred from blindly falling and stumbling within somnambulism, not to mention the disruption of the sleep of those whom they live with.
As Dr. John Winkleman, Associate Professor at Harvard Medical School wrote in a recent editorial for SLEEP, the official publication of the Associated Professional Sleep Societies, “Hunger and sleep are fundamental biologic drives under the control of both homeostatic and circadian influences. Nocturnal eating disorders occur when the coordination of these 2 drives is dysregulated, resulting in the disordered eating of a daytime eating disorder combined with the disordered sleep of a sleep disorder.”
In other words, Nocturnal Sleep Related Eating Disorder (NSRED) occurs when both sleep cycles and eating cycles become disrupted, causing an amalgamation of the two during sleeping hours. NSRED is often paired, but not to be confused with Night Eating Syndrome (NES), this is classified as an eating disorder whereby the sufferer consumes more calories after their evening meal than the meal itself and the previously consumed calories from the rest of the day.
Though NES results in sufferers getting out of bed during the night to snack, the eating in this case is conscious and paired with feelings of guilt and anxiety. NES sufferers often have morning anorexia and eat very little during daytime.
A study by the Minnesota Regional Sleep Disorders Center differentiates the two claiming that “NSRED is characterized by inappropriately consuming food after falling asleep, whereas NES is characterized by hyperphagia [insatiable appetite] after the evening meal, either before bedtime or after fully awakening during the night.”
NSRED is more common in women than men and is usually connected to a pre-existing factor.
Dr. Michel A. Cramer Bornemann, lead investigator of Sleep Forensics Associates, and Director of Sleep Medicine Services HealthEast Care Systems of Minnesota tells BTR, “Predisposing factors and a prior disposition to sleep walking can contribute to the cause of this this condition.”
He explains that other sleep disorders such as restless leg syndrome and sleep apnea can also contribute. Dr. Cramer Bornemann goes on to describe how the sleeping pill Ambien has been found to be a significant factor in the cause of NSRED.
“The rampant insomnia common in females aged 22-39 [the demographic with the highest levels of NSRED] is often treated with Ambien,” Dr. Cramer Bornemann urges physicians to be more practical in their approach to medicating insomnia knowing the effects it can have on patients.
As for why it affects women more than men, we cannot know yet Dr. Cramer Bornemann continues, “Perhaps hormones and certain parts of the brain are responsible, but this is something we do not know for sure yet.”
The dangers of this extreme form of sleepwalking are vast. From tripping and falling to cutting oneself on knives and cans attempting to prepare food, burns and scalds and the consumption of hot liquids and solids like oatmeal are common. The Minnesota Regional Sleep Disorders Center finds that patients often eat dry cereal, candy, bread and peanut-butter but have also had patients eating a more unusual array of night time delicacies such as uncooked spaghetti, salt and sugar sandwiches, frozen foods and pet food.
The more dangerous things that people with NSRED have consumed during a nocturnal binge the study finds, are egg shells, glue and cleaning products and bizarrely, buttered cigarettes.
“The individual is afflicted personally by their own careless manipulation of kitchen equipment while they are attempting to prepare food while asleep,” Dr. Cramer Bornemann illustrates. He knows of one patient who caught on fire whilst trying to prepare food in their sleep and required skin grafts to heal the burns.
“This unconscious behavior also poses a threat to the patient’s family as fires and other safety issues can occur.”
The treatment for Nocturnal Sleep Related Eating Disorder involves identifying the individual patient’s pre-existing conditions that fragment sleep and treating them accordingly.
“Tompmax is a drug used to alleviate migraines and epilepsy which has proven effective in the treatment of patients with Nocturnal Sleep Related Eating Disorder,” Bornemann tells BTR.
Nocturnal Sleep Related Eating Disorder plagues the lives of many women ages 22 – 39. The adverse consequences of this condition include weight gain and the subsequent grief that that causes, potential diabetes and the low recall of the circumstances in which the food was consumed leads to feelings of guilt, anxiety and depression.
Explains Bornemann, “The behaviour of NSRED is without motivation and intent, it causes patients feelings of overwhelming guilt and when they realise what they’re doing.”
Although every case of Nocturnal Sleep Related Eating Disorder is circumstantial and related to a pre-existing condition, there are treatments available to prevent comatose night time kitchen raids and leave the eating to the conscious.