Sleep-related eating disorder is a sleep disorder in which a person eats while partially asleep. Unlike other disorders related to eating, people with a sleep-related eating disorder are usually unaware of nighttime episodes. We cover what causes sleep-related eating, its effects, and what treatments are available.
What Is Sleep-Related Eating Disorder?
Sleep-related eating disorder (SRED) is a type of parasomnia, a group of sleep disorders involving unusual behaviors while falling asleep, during sleep, or while waking up. People with an SRED fall asleep normally, then partially awaken to eat or drink.
Experts do not know exactly how many people have an SRED, but it may affect up to 5% of the population. This sleep disorder is reported much more commonly among women.
Like people who sleepwalk, those with an SRED are often unaware of their behavior. People with an SRED may consume foods and substances that can make them sick, such as pet food, salt, cleaning products, or raw meat. They may also try to cook while they are still partially asleep.
Sleep-Related Eating Disorder vs. Other Eating Behaviors
Sleep-related eating disorder isn’t the only condition in which a person has abnormal eating behaviors.
Eating disorders are medical conditions that affect a person’s thoughts, emotions, and actions related to food. Although a person can have both an eating disorder and SRED, daytime eating disorders differ in that they are associated with either an intense fear of gaining weight or a loss of control over their eating.
Night eating syndrome is another condition involving abnormal nighttime eating. A person with night eating syndrome eats excessively after dinner or wakes up at night to eat but, unlike SRED, they are always fully aware of episodes. Nighttime eating disorder is not an eating disorder, but may develop into one if symptoms become sufficiently severe.
Signs and Symptoms of Sleep-Related Eating Disorder
The primary symptom of a sleep-related eating disorder is waking up from sleep to eat or drink, without full conscious awareness. The condition may involve several additional signs and symptoms.
- Consuming inedible substances: People with an SRED may eat and drink raw, toxic, unappetizing, or inedible things, including pet food, cleaning products, and cigarettes. They may also consume raw meat, uncooked frozen products, or other bizarre combinations of foods.
- Preparing food while asleep: Some people with a sleep-related eating disorder attempt to cook during an episode. This may result in injuries or burns.
- Feeling irritated when interrupted: People with a sleep-related eating disorder are typically difficult to awaken during an episode. When an episode is interrupted, they may become agitated or upset.
- Having little or no awareness: Most of the time, a person does not recall getting out of bed and eating or drinking. Some people may faintly remember having an episode, while others are unaware during an episode but recall it the next morning.
What Causes Sleep-Related Eating Disorder?
Sleep experts do not know exactly what causes a person to develop a sleep-related eating disorder. However, researchers point to potential problems in how the brain regulates wakefulness and sleep, which may cause a person to perform activities when their body is still partially asleep.
Experts have identified several factors that often appear alongside or potentially trigger nighttime episodes.
Other Sleep Disorders
Experts estimate that more than half of people diagnosed with a sleep-related eating disorder are first diagnosed with another type of parasomnia.
SRED shares some similarities to sleepwalking, and some experts think the condition may be a variant of sleepwalking. Evidence suggests that nearly 70% of people with an SRED also sleepwalk or have done so in the past. In tests, sleepwalkers and people with an SRED tend to demonstrate similar levels of consciousness and brain activity.
Other sleep disorders, like obstructive sleep apnea, narcolepsy, and restless legs syndrome, may contribute to an SRED because they cause a person to wake up more often at night. Some medications used for restless legs syndrome may also trigger nighttime episodes.
Several medications can potentially trigger episodes of sleep-related eating disorder. These include medications to treat mental health conditions, like lithium as well as antipsychotic medications. Other medications include sedative hypnotics, which are used to help people fall and stay asleep.
Research suggests that people with medication-induced SRED tend to develop the condition at an older age. They are also less likely to have a history of sleepwalking, and typically remember little or nothing about nighttime episodes.
Medical Conditions and Other Factors
Several medical conditions can trigger SRED, including fever, hepatitis, and a distended bladder.
People may also develop an SRED when they are under severe stress or after they quit smoking, drinking alcohol, or using illegal drugs. Symptoms may also begin after a person begins dieting during the day, when they menstruate, or when they experience sleep loss.
Risks of Sleep-Related Eating Disorder
Sleep-related eating disorder can negatively impact a person’s physical and mental health in a variety of ways.
- Poisoning and foodborne illness: Some individuals consume toxic substances during an episode. They can also contract food poisoning from eating raw, contaminated, or undercooked food.
- Injuries and property damage: People who cook during episodes run the risk of starting fires, cutting or burning themselves, or consuming dangerously hot foods and drinks.
- Weight gain: People with an SRED tend to consume high calorie foods when they sleep eat. Over time, this may lead to overweight or obesity.
- Dental problems: Eating frozen foods can result in broken or damaged teeth. People may fall asleep with food still in their mouth, which puts them at risk for tooth decay.
- Other health problems: Sleep eating can contribute to a host of medical issues, including allergic reactions, high cholesterol, high blood pressure, and diabetes.
- Discouragement and depression: It’s not uncommon for people to become sad, frustrated, or depressed when they are unable to prevent nighttime episodes.
How to Treat Sleep-Related Eating Disorder
Treatments for sleep-related eating disorder vary based on what doctors believe to be triggering nighttime episodes. For people whose symptoms may be linked to medications, treatment often involves stopping or changing the medication. This is often enough to improve symptoms.
In people who have other sleep disorders that may be contributing to SRED, doctors may focus on treating underlying sleep issues first.
Other treatments for SRED include medications and changes to the sleep environment to promote better rest and prevent harm during episodes.
- Avoid sleep loss: Sleep deprivation is a potential trigger for SRED. Avoiding anything that disrupts sleep and maintaining healthy sleep habits may help to prevent sleep loss.
- Keep food secured away: If a person tends to seek a specific food during episodes, it may be best to keep those foods out of the kitchen. It can help to lock the refrigerator and cabinets that contain food, and hide chemicals and inedible substances, if necessary.
- Secure doors: To prevent sleep eating before it starts, people can put an alarm on the bedroom door. If it’s safe, barriers in front of the entrance to the kitchen may also be helpful.
- Reduce stress: Stress can trigger nighttime episodes of SRED. It may be helpful for people to reduce daytime stress and find relaxing activities before bed.
When to Talk to Your Doctor
If you’re concerned about eating in your sleep or notice symptoms of sleep-related eating disorder, you should talk to your doctor. Consider keeping a sleep diary to track your sleep habits. Since you may not be fully aware of nighttime episodes, bed partners, roommates, or family members may also be able to provide valuable insight.
Because sleep-related eating disorder is frequently associated with medications and other sleep disorders, be sure to tell your doctor about medicines you take and other sleep-related symptoms.