Snacking While Asleep? The Truth About Nocturnal Eating Disorders

Do you wake in the night and eat? Sleep eating is more common than you think.

Sure, everyone likes a good bedtime snack, but for some people, nighttime eating stretches beyond that final bowl of ice cream before turning in. These people find themselves inadvertently snacking the night away, either knowing or unknowingly, in the form of nocturnal eating disorders, or NEDs.

There are two types of these eating disorders, nocturnal eating syndrome (NES) and sleep-related eating disorder (SRED). The main difference between the two sleep disorders is that during NES, the person is fully aware of their actions, but with SRED, the person only partially wakes up and then unknowingly begins sleep eating. Between 1 and 3 percent of the general population is thought to have one of these nocturnal eating disorders, which are considered both an eating disorder and a sleep disorder.

People with NES will wake up during the night and have an uncontrollable urge to eat, regardless of how hungry they are. In fact, many people with NES are unable to fall back to sleep unless they eat.

People with SRED partially awaken in the middle of the night in a situation similar to sleepwalking and other sleep disorders, and then start sleep-eating, which normally entails unconsciously eating a large amount of typically unhealthy, high-calorie foods. Unlike NES, during which people remember their nighttime eating, those with SRED may not remember sleep eating or may only partially recall the event in the morning. Many times, when they find their kitchen a mess the next morning, they have no idea how it got that way.

Nocturnal eating disorders, if left untreated, can lead to significant weight gain and other health problems, such as type 2 diabetes, hypertension, and depression. “If you suspect you have a nighttime eating disorder, speak with your doctor,” said David Schulman, MD, MPH, chief of pulmonary and critical care medicine at Emory University Hospital in Atlanta.

The Causes Behind Nocturnal Eating Disorders

Sleep eating disorders are seen in both children and adults. They are more common in women, as most eating disorders are, and occur more often in people under the age of 50. Nocturnal eating disorders can be the result of an underlying medical problem, such as stomach ulcers, sleep apnea, or depression, other eating disorders such as bulimia, other sleep disorders such as sleepwalking, or a traumatic event. Zolpidem (Ambien), a prescription sleep aid, may also cause nighttime eating.

In addition, SRED can affect people who are on diets or who are under a large amount of stress. They may go to bed hungry because of their restricted diet and then unconsciously eat at night.

The Signs of Nocturnal Eating Disorders

If you exhibit the following behaviors for at least two months, you may have nocturnal eating syndrome:

  • You frequently wake at night and feel that you must eat in order to go back to sleep.
  • You eat more food after dinner than during dinner — more than half of your daily food intake comes after dinner.
  • You have little or no appetite for breakfast.

Symptoms of sleep-related eating disorder may include:

  • Seeing evidence of nocturnal eating when you get up in the morning, such as food left out on a counter or a disheveled kitchen
  • Having little or no appetite in the morning
  • Experiencing significant weight gain
Treating Nocturnal Eating Disorders

If you suspect that you have a nocturnal eating disorder, talk to your doctor about getting a full health evaluation to rule out other conditions that may be causing the symptoms. A sleep study may be recommended to detect unusual sleep behaviors.

Once an accurate diagnosis is made, medications may be prescribed to treat nocturnal eating. Topiramate (Topamax) is an anti-seizure medication that can be used to treat both NES and SRED. “It works on the appetite center of the brain to dull it a little,” explains Dr. Schulman. “It also helps with weight loss.”

If depression is causing your nighttime eating, an antidepressant may be prescribed along with counseling and support. In addition to drug treatment, minimizing alcohol consumption, which can disrupt sleep, and reducing stress may help prevent nocturnal eating.

If you think you may have a nocturnal eating disorder, take steps to get help. Nocturnal eating “is a medical disorder that can be treated,” says Schulman. “If you suspect you have it, talk to your doctor.”

Hedy Marks