Night-Eating Syndrome: Much More Than Midnight Snacks

People with the condition eat compulsively and don't remember it

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By
HealthDay Reporter

TUESDAY, July 2, 2002 (HealthDayNews) -- If you wake up and find crumbs in your bed or the remains of a food fest in the kitchen, you could have Night-Eating Syndrome.

Also called Nocturnal Sleep-Related Eating Disorder, it is a real but little understood condition in which people wake from sleep and compulsively binge on large quantities of food.

Often, people with the disorder eat while in a state of altered consciousness, similar to sleep-walking, and don't remember eating, says Lea Montgomery, who wrote an article about sleep-eating and how to diagnose it in a recent issue of RN.

"There is so much shame involved with this," says Montgomery, an instructor in nursing at Texas Christian University's Harris School of Nursing in Fort Worth. "We need to educate doctors and the public that this is a real phenomenon, that it is dangerous and serious."

Doctors aren't quite sure why people sleep-eat, or even whether to classify it as a sleep disorder or an eating disorder, says Edward Abramson, author of several books on "emotional eating" and a professor of psychology at California State University in Chico.

An estimated 1.5 percent of Americans have experienced night-eating. The rate is higher in obese people.

About 10 percent of people seeking help at obesity clinics are night eaters, one study found. About 25 percent of those getting surgical treatment for obesity are night eaters, says Abramson, who has a private practice in Lafayette, Calif.

Night-Eating Syndrome was first diagnosed in 1955, but there have been only a few studies on it since, Abramson says.

One study linked night-eating to disturbances in sleep patterns caused by conditions such as restless legs syndrome or sleep apnea. It's possible these conditions cause partial awakenings that could trigger night-eating, Abramson says.

Another study linked night-eating to abnormal levels of melatonin and cortisol, hormones involved in regulating sleep and stress.

Many night-eaters have trouble falling asleep. Also, many awaken several times during the night to eat, research has found.

One study revealed that night-eaters have little appetite during the day, but scarfed down food at night. Another study found obese people without Night-Eating Syndrome consumed 74 percent of their food intake by 6 p.m. Obese people who were night-eaters consumed only 37 percent of food intake by 6 p.m.

While some patients remember eating, others are surprised to find the remnants of food in their kitchens and bedrooms in the morning.

Sleep-eating can be dangerous, Montgomery warns. People can walk into walls, cut themselves on can openers and burn themselves with hot food.

Sleep-eaters primarily consume foods high in sugar or fat, such as peanut butter or snack foods. However, there are even reports of people eating non-food items such as cigarettes, nail polish, cat food or still-frozen dinners.

Montgomery first became aware of sleep-eating a few years ago.

She had a patient, a woman in her 40s, who would wake up in the middle of the night, go to the kitchen and gorge herself. She'd eat butter straight from the butter dish or a whole tray of brownies.

"She tried to get help, but doctors and therapists were not taking her seriously," recalls Montgomery, who eventually helped the woman learn more about the disorder. "She was dismissed as being neurotic."

Some people with Night-Eating Syndrome install motion detectors in the kitchen and lock the refrigerator door, Montgomery says. While this might stop them from eating, it doesn't deal with the underlying causes.

Many with Night-Eating Syndrome are helped by establishing a routine for bedtime, exercising regularly, staying away from caffeine after lunch, avoiding sedatives and alcohol three to four hours before bedtime, and losing weight.

Some drugs can also be effective, including L-dopa, a drug used to control levels of dopamine in the brain, and anti-seizure medications.

What To Do

To read more about Night-Eating Syndrome, visit Stanford University or read this editorial in the Journal of the American Medical Association.

SOURCES: Lea Montgomery, R.N., instructor, nursing, Texas Christian University's Harris School of Nursing, Fort Worth, Texas; Edward Abramson, Ph.D., professor, psychology, California State University, Chico, Calif.

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