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Going Bump in the Night

Some people really do walk, even eat, in their sleep

WEDNESDAY, Oct. 30, 2002 (HealthDayNews) -- Forget about things that go bump in the night. Try people who go bump in the night.

Or shriek, grind, mumble, thrash about or even eat in their sleep.

These are all symptoms of "parasomnias," sleeping disorders that include sleep-talking, teeth grinding, night terrors and, yes, even sleep-eating.

"Parasomnia really means a sleep-related disorder, but one that seems to be associated with some possible wakefulness or wakefulness-like activity such as eating or walking," says Gary Zammit, director of the Sleep Disorders Institute at St. Luke's-Roosevelt Hospital in New York City. "The person has the sensation that something is real."

There is little to link the various conditions, not even an underlying medical or psychological problem, though they can worsen under stress.

"They commonly occur during slow-wave sleep, which is a very deep sleep," Zammit says. "This may be the one thread that runs through them."

Tooth-grinding is the exception: It occurs during a different phase of sleep.

Sleep disorders affect adults, but are much more common among children. The prevalence of sleepwalking in children, for instance, is about 15 percent. Most will lose the tendency as they grow older.

Sleep-eating is relatively rare and involves both walking and eating while asleep.

These two behaviors -- walking and eating while asleep -- can be hazardous, especially for adults who no longer have a watchful parent living with them. Zammit has had patients who were sleepwalking in the middle of a street or who cut themselves after turning on the blender and putting their hand in.

Sleep-eaters will arrive in his office after consuming "non-nutritive" substances, he adds.

"One person was eating garbage and not only from his own garbage, but he was walking out onto the street on garbage night," Zammit says. "He was getting pretty sick."

Treatment often involves common sense.

"For a sleepwalker, one of the first things a doctor may do is have the sleepwalker make sure that his or her environment is a safe one at night. Make sure doors are well-locked and that there's no debris on the floor that they can trip on," Zammit says.

If you have a family member who walks while asleep, don't try to wake him or her up as they're likely to startle and strike out.

"Try to guide the person back to bed, otherwise you could get a black eye," Zammit says.

Keep in mind that real sleepwalkers don't look like they do in the movies, with hands stretched out in front of them. Usually, they're fumbling around, their movements much less coordinated than when they're awake.

Many sleep-eaters are "restricters," meaning they restrict their food intake during the day. Their night eating may be an attempt to make up for the daytime deprivation.

"We know that night-eaters tend to consume high-fat foods or high-carbohydrate foods during the night, so we have them eat fatty or carbohydrate foods late in the evening before they get into bed," Zammit says.

Another "treatment" is to have the patient prepare a "safe" food tray with carrots and celery sticks placed near the bed for their night-time noshing.

"By altering food patterns, we can sometimes take the behavior away entirely," Zammit says. "The reward of getting up and eating is taken away so the problem goes away."

Medications are a last resort, though these are not usually recommended for children.

Most often people don't even know what they're doing unless a roommate or a bedmate points it out or until they fall off a step or watch the scale creep higher and higher.

That's the really scary part. One man walked out onto his New York City balcony one night and woke up there. "He was very fortunate because when you're out of touch with the environment, you're not reacting to the environment," Zammit says. "He could have tripped or leaned the wrong way or fallen off."

What To Do

For more information on parasomnias, visit Stanford University. More general information on sleeping disorders can be found at the American Academy of Sleep Medicine or the National Center on Sleep Disorders Research.

If you'd like to inquire about ongoing clinical studies at St. Luke's-Roosevelt Hospital, call 212-523-1780.

SOURCE: Gary Zammit, Ph.D., director, Sleep Disorders Institute, St. Luke's-Roosevelt Hospital, New York City
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