Sleep Eating: Why Do I Eat In My Sleep?

Sleep-related eating disorders (SRED) are parasomnia conditions that cause people to binge eat during the night while in a sleepwalking state of mind. People with SRED are often unaware of their actions and may eat strange combinations of food, including inedible or potentially dangerous substances. Night eating syndrome (NES) is another eating disorder that causes people to eat excessively at night or wake up in the middle of the night to eat. This can be due to several factors, including genetics, daytime dieting, and underlying medical or mental health conditions. If you suspect you have a sleep-related eating disorder, it is important to speak with a doctor or a sleep specialist for diagnosis and treatment.

Characteristics and Values Table for Sleep Eating Disorders

Night Eating Syndrome (NES) is an eating disorder associated with fragmented sleep

Night Eating Syndrome (NES) is an eating disorder characterised by the consumption of a significant proportion of one's daily calories after dinner and during nocturnal awakenings. It is associated with fragmented sleep, with affected individuals waking up multiple times a week to eat. This can lead to poor sleep quality and various chronic health issues, such as cardiovascular disease and diabetes. NES is often accompanied by insomnia or other sleep disorders, and those affected may experience changes in hormones that regulate sleep, hunger, and stress, such as melatonin, leptin, ghrelin, and cortisol.

NES is a unique condition with symptoms that overlap with mood, sleep, and other eating disorders. It is prevalent in 6% to 16% of individuals with obesity, although the causal relationship is unclear. NES is also more common in people with depression, anxiety, or other psychiatric disorders. Risk factors include genetic predisposition, stress, and inadequate calorie intake during the day.

The diagnosis of NES does not depend on an individual's weight but rather on specific criteria, such as the Night Eating Symptom History and Inventory (NESHI) or the Night Eating Symptom Scale. Treatment options for NES may include cognitive behavioural therapy, antidepressant medications, progressive muscle relaxation, light therapy, melatonin supplements, hypnotherapy, and weight management programs.

NES can significantly impact an individual's health and well-being, leading to feelings of exhaustion and a lack of control. Seeking professional help is crucial, as healthcare providers can create tailored treatment plans based on symptoms, emotional well-being, and underlying health conditions.

Sleep-related eating disorder (SRED) is a parasomnia, like sleepwalking

Sleep-related eating disorder (SRED) is a parasomnia, a type of abnormal behaviour that occurs during sleep. It is characterised by recurrent episodes of eating and preparing food while asleep, with little to no memory of the event upon waking. SRED is often associated with other primary sleep disorders such as sleepwalking, restless leg syndrome, and obstructive sleep apnea syndrome. It can also be caused by certain medications, particularly sedatives used to treat insomnia.

People with SRED may eat a large proportion of their daily food intake at night, either after dinner or during nighttime awakenings. They may crave sweets and high-calorie, carbohydrate-rich foods. This can lead to weight gain and an increased risk of chronic health conditions such as cardiovascular disease and diabetes. The disorder can be dangerous, as those affected may eat non-food items that are harmful or poisonous, and they are also at risk of injuries such as burns and cuts.

The exact causes of SRED are not fully understood, but it is believed to be related to disruptions in the body's internal clock, which normally synchronises sleep and meal patterns. It is also associated with changes in hormones that regulate sleep, hunger, and stress, such as melatonin, leptin, ghrelin, and cortisol. SRED is more common in people with obesity, depression, anxiety, and other psychiatric disorders.

Treatment for SRED aims to address the underlying causes and may include cognitive behavioural therapy, medication such as selective serotonin reuptake inhibitors (SSRIs), progressive muscle relaxation techniques, light therapy, and melatonin supplements. Lifestyle changes, such as improving sleep habits and addressing any co-occurring mental health conditions, can also help manage the disorder.

If you suspect you are experiencing SRED, it is important to seek help from a healthcare provider. They can work with you to develop a treatment plan that addresses your specific needs and ensures your safety during nighttime episodes.

NES is more common in people with other eating disorders, such as binge eating disorder or bulimia

Night Eating Syndrome (NES) is a type of eating disorder characterised by eating after dinner and when awake at night. NES is often accompanied by a sleep disorder, such as insomnia, and can cause multiple wake-ups per night to eat. NES is more prevalent in individuals with other eating disorders, such as binge eating disorder or bulimia nervosa, and can lead to obesity and related health complications if left untreated.

NES is characterised by several symptoms, including eating a significant portion of daily food intake after dinner and before breakfast, craving high-calorie, carbohydrate-rich, or sugary foods at night, and the conscious awareness of night eating episodes. NES can affect an individual's ability to function during the day, leaving them feeling unrested and unmotivated to eat breakfast.

The prevalence of NES is estimated at 1.5% in the United States, affecting approximately 5 million people. NES is more common among individuals with other eating disorders, such as binge eating disorder (BED) or bulimia nervosa. Research has found that NES patients present with elevated eating disorder pathology, including emotional eating and loss of control eating. The overlap between NES and BED has been a subject of debate, with some arguing that BED can be differentiated by a higher occurrence of emotional eating and body-related concerns. However, the differences between the two disorders are still under-researched.

NES is often comorbid with depression and other psychiatric disorders, and stress has been shown to exacerbate its symptoms. Treatment for NES typically involves a combination of approaches, including cognitive-behavioural therapy (CBT), antidepressant medications, progressive muscle relaxation, light therapy, and melatonin supplements. Hypnotherapy is also suggested as a way to manage conditions like obesity, which is associated with NES.

If you suspect you may be experiencing NES or another sleep-related eating disorder, it is important to seek professional help. A healthcare provider can evaluate your symptoms, which may include keeping a sleep diary, and recommend an appropriate treatment plan to address your specific needs.

NES is also more common in people with mental health problems, like depression, anxiety, low self-esteem, or substance abuse

Night Eating Syndrome (NES) is a sleep-related eating disorder characterised by the consumption of a significant proportion of one's daily calories after dinner or during nighttime awakenings. This can occur several times a week, with multiple wake-ups per night. NES is associated with fragmented sleep, causing individuals to wake up to eat and resulting in poor sleep quality.

NES is more prevalent in individuals with mental health issues such as depression, anxiety, and other psychiatric disorders. The bidirectional relationship between sleep and mental health suggests that sleep problems can contribute to the onset and worsening of mental health issues, while mental health problems can also lead to poor sleep. For instance, insomnia is recognised as a symptom of psychiatric disorders, but it can also exacerbate conditions like depression, anxiety, and even increase the risk of suicidal ideation.

The link between NES and mental health may be influenced by various factors. One factor is the body's internal clock, which in individuals with NES, may not synchronise sleep and meal patterns. This misalignment can result in changes to hormones that regulate sleep, hunger, and stress, such as melatonin, leptin, ghrelin, and cortisol. Additionally, individuals with NES may not be consuming enough calories during the day, leading to increased hunger and night-time eating.

Treating NES often involves addressing both the eating and sleeping aspects of the disorder. Cognitive behavioural therapy (CBT) can help individuals adopt healthier habits and address underlying behaviours. Antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs), can improve mood and regulate emotions. Progressive muscle relaxation techniques can help individuals relax their muscles, de-stress, and prepare for sleep. Light therapy can also be beneficial in adjusting the circadian rhythm, promoting sleepiness at night and wakefulness during the day.

NES can be treated with tools such as therapy, medications, and lifestyle changes

Night Eating Syndrome (NES) is a type of sleep-related eating disorder (SRED) that can be treated with therapy, medication, and lifestyle changes. SRED is a type of parasomnia, which is abnormal behaviour that occurs during sleep. People with SRED eat food while sleeping and do not remember it in the morning. NES, specifically, occurs during non-REM sleep and is associated with low sleep efficiency. It is characterised by compulsive eating of high-calorie foods at night, poor sleep quality, and morning anorexia. NES usually begins in early adulthood and is more common in females.

If you think you may have NES, it is important to see a healthcare provider for an evaluation. They will check for any underlying health conditions that might be causing you to wake up at night and ask about your symptoms, sleep patterns, and emotional state. They may also recommend that you keep a sleep diary.

Treatment for NES can include:

• Cognitive Behavioural Therapy (CBT): This type of talk therapy can help address certain behaviours and encourage healthier habits.
• Medication: Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) can boost your mood and regulate your emotions. Other medications that have been used to treat NES include topiramate, clonazepam, and pramipexole.
• Progressive Muscle Relaxation (PMR): This technique helps to relax the muscles, de-stress, and prepare the body for sleep.
• Light Therapy: Adjusting your circadian rhythm can help you feel sleepy at night and awake during the day.
• Melatonin: Taking melatonin supplements can help regulate your sleep-wake cycle.
• Safety Measures: Placing locks on refrigerators or cabinets, setting alarms, and removing hazards from your path can help keep you safe during sleepwalking episodes.
• Treating Underlying Conditions: NES is often associated with other sleep disorders, mental health conditions, or medical issues. Treating these underlying conditions may help reduce NES symptoms.

In addition to professional treatment, lifestyle changes can also help manage NES:

• Eating enough during the day: Ensuring you consume sufficient calories and nutrients throughout the day may reduce nighttime hunger.
• Adjusting your routine: Reflect on your daily routine and consider whether changes, such as incorporating more exercise, could help reduce night-time eating.
• Getting enough sleep: Aim for at least 7 hours of sleep per night to reduce the likelihood of nocturnal eating.

If you are experiencing distress or need urgent support, you can also reach out to eating disorder and mental health hotlines. These services provide a safe and confidential space to discuss your feelings and receive guidance and resources.

Frequently asked questions