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Saturday, July 24, 2010

Coping with Sleepwalking and Sleep Eating

Since I can’t watch TV during the day I tape my favorite shows so I can watch them at night.  Recently on Doctor Oz he did a segment on sleep eaters. My friend and associate, Dr. Luke Sleepwalker finds that people who are sleepwalking will binge on food, take a walk outside or even think their closet is the bathroom!  Reports have shown that up to 1 million adults could be sleepwalkers who eat, in fact, may patients who are obese have been diagnosed with a sleep-eating condition   Sleep eating could be dangerous not only because of the extra calories and fat you consume in your sleep, but some people will even eat nonfood items like cigarettes or toxic cleaning products.

The guest on Dr. Oz’s show said the most bizarre thing she ever ate in her sleep was a steel wool cleaning pad, and it was only when her nephew told her about this that she realized she was sleepwalking and eating.  You’d think if the nephew would have stopped her before ingesting the pad.  Very often, people who do sleep-eating are either on restrictive diets during the day or prescription sleep pills.  Restrictive dieting or medications can alter your ability to become paralyzed while asleep, therefore you can act out during REM sleep.  In REM sleep you dream and your body naturally paralyzes itself so you don’t act out. 

Doctors have classified the nighttime sleep-related eating disorder (SRED) as parasomnia which is a category of sleep disorders related to sleepwalking (somnambulism), night terror and periodic limb movement disorder. People with SRED sleepwalk their way to the kitchen to forge on food and nonfood items more than one time during the night.  Not only is obesity an issue these folks can experience cuts and burns are they try to prepare food and could also be life-threatening for those that are diabetic and must monitor their diet for proper insulin management. Because sleep-eaters get up through the night they never experience an uninterrupted night’s sleep which can cause mental and physical side effects such as memory loss, fatigue, depression, limited motor skills and even heart decease.

Dr Sleepwalker also talks about night-eating syndrome (NES).  Different from SRED this is an eating disorder associated with people having trouble falling asleep and staying asleep and usually suffers from insomnia.  NES sufferers eat dinner between 8pm and 6am and eat uncontrollably with a continued urge to eat during periods of wakefulness.  People with NES consume 50% of their daily calories at night eating high-calorie carbohydrates.

Another nocturnal nuisance is night-eating syndrome (NES). This problem is a little different from SRED and may technically not be a sleep disorder, but an eating disorder instead. Many people with NES however have trouble falling or staying asleep, a symptom of insomnia, which is why the lines are blurred to its classification. Alternatively, NES and SRED may be part of the same syndrome, but different parts of the spectrum. Regardless, this problem can be equally detrimental to one's health.  These people are at high risk for substance abuse and depression.

If you feel you have SRED or NES it is advised to seek medical counseling as a medical professional can diagnosis your disorder though a proper sleep study.  In order to help the doctor determine the correct treatment there are a few steps you can take such as; medical exam, keep a sleep journal, review all drugs, over-the-counter medications and supplements, establish a sleep routine, get rid of high calorie foods and make note of your calorie intake. Sleep-eating is associated by sleepwalking and excess nocturnal overeating known as compulsive hyperphagia.  Even though sleep-eaters are unaware and unconscious of their behavior there are sketchy memories and signs that they are in fact suffering from this condition.  A messy kitchen, candy wrappers on the floor, food smeared on face and hands and/or indigestion.

In fact 1 to 3 percent of the population is affected by sleep eating and more common among younger women in their late 20’s. Also sleep-eating may be genetically linked and those affected have a history of alcoholism, drug abuse or another sleep disorder and is directly linked to the onset of another medical problem that is why it is necessary to seek professional care from a doctor or sleep specialist to determine any underlying causes. Underlying causes may include sleep apnea, restless leg syndrome, drug abuse, drug withdrawal, chronic autoimmune hepatitis or acute stress.   
Treatment for those that have been diagnosed with a sleep-eating disorder may find interventions available to them other than prescription medication. If their condition is caused by acute stress, stress management courses or hypnosis may be recommended.  Lifestyle changes such as a change in diet, eating at different times during the day and reducing caffeine and alcohol maybe an alternative to medication.  If the underlying problem is sleepwalking, some medications have been found to be helpful are those in the benzodiazepine family.  Supplements such as GABA are known to help those with restless leg syndrome (RLS). 

Another similar sleep-related eating disorder that is different from sleep eating the individual is awake during episodes of nocturnal bingeing. This disorder has many names: nocturnal eating (or drinking) syndrome, nighttime hunger, nocturnal eating, night eating or drinking (syndrome), or the "Dagwood" syndrome. Affected individuals, usually children, are physically unable to sleep without food intake and are experiencing weight gain as well as insomnia. 

This is usually behavioral as infants are conditioned to have a bottle right before bedtime.  As the child grows they continue to have a drink or a bedtime snack and refuse to go to bed unless their request is granted. 

Eating or drinking at night is usually a conditioned, conscious behavior, although it is a disorder, in many cases night eating is not caused by a mental or physical condition and can be corrected with healthy lifestyle changes.  Undue stress, an ulcer or Hypoglycemia (low blood sugar) has also been projected as a possible cause of nighttime eating. Low blood sugar can be determined by a glucose tolerance test.

Treatment for an adult with night eating should be determined by a physician so they can rule out another condition such as Hypoglycemia. Correcting the behavior may take longer with an adult than with a child, but overtime establishing a healthy daily life by eating smaller more frequent meals, reducing carbohydrates while increasing proteins before bedtime and reducing stress may help.  Protein metabolizes slowly and stabilizes the blood sugar levels which should help alleviate the uncontrollable urge to eat and drink often late at night and for those that suffered from night eating should fall sleep and stay asleep through the night.

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