| Nocturnal Eating Syndrome (Sleep-Related Eating) is considered a parasomnia, and is a rare type of sleepwalking, a disorder of arousal. People with this disorder experience recurrent episodes of eating during sleep, without being aware of what they are doing. Sleep-related eating might occur often enough to result in significant weight gain. Although it can affect all ages and both sexes, it is more common in young women. Ever felt an uncontrollable urge to raid the fridge late at night? You could be suffering from a medical condition. Scientists believe that 1.5% of the general population might suffer from a condition known as Night Eating Syndrome. Dr Albert Stunkard, who first spotted the symptoms in 1955, said the condition was not merely a habit but a real clinical illness marked by changes in hormone levels. Most people who suffer from the syndrome are prone to stress, and to poor sleep, often waking three to four times a night. Each time they wake they head for the kitchen to eat a "snack" of high carbohydrate food such as biscuits, cakes or crisps. Night eaters take in fewer calories than other people during the day and often skip breakfast, Dr Stunkard told fellow experts at the International Conference on Eating Disorders in London. But between about 9pm and the following morning they might consume half their total calorie intake. While they do not gorge themselves, night eaters consume on average 500 calories a day more than normal eaters. As a result, many of them are overweight. Officially recognised Dr Stunkard expects to publish the first officially recognised description of Night Eating Syndrome in an American scientific journal in about two or three months time. He said night eaters suffered three separate problems - an eating disorder, a sleeping disorder and a mood disorder. As they became more anxious and depressed during the night, their eating increases. Dr Stunkard, professor of psychiatry at the University of Pennsylvania, USA, suspected sufferers were eating to help themselves sleep by boosting levels of a brain nerve message chemical called serotonin. He said: "I think they are eating to medicate themselves because the eating is very high in carbohydrates, and carbohydrates are likely to increase the serotonin in the brain, and that stimulates sleep. "I think stress triggers it but you have to have a specific kind of make-up to respond in this way, and I think that's genetic." He said almost 10% of the obese patients he saw at his eating disorder clinic in Philadelphia probably suffered from Night Eating Syndrome. However, not all sufferers were obese. He added that one study suggested that in the general population about 1.5% of people may have the condition. In Britain that would mean around 900,000 people. The illness had not been seen in children and probably did not afflict adolescents. It was likely to be more common among women than men. Hormone link Tests had shown that people with the condition experienced a decrease during the night in levels of two hormones linked to sleep and appetite, melatonin and leptin. At the same time levels of the stress hormone cortisol, rose. This suggested that it may be possible to treat night eating with melatonin and leptim to promote sleep and reduce feelings of hunger. Asked what damage habitual night eating might do, Dr Stunkard said: "The major harm is that people are made very distraught by it. They don't get enough sleep and a lot of them are sleeping during the day. It may also contribute to obesity because these people are eating more than other people." He said carbohydrates stimulated the production of insulin, which led to elevated levels in the brain of tryptophans - the substances from which serotonin is derived. As well as helping people sleep, serotonin is a "feel-good" chemical which wards off depression. Dr Stunkard said this explained why high carbohydrate products are often described as "comfort food". In spite of its name, NS-RED is not, strictly speaking, an eating disorder. It is thought to be a type of sleep disorder in which people eat while seeming to be sound asleep. They may eat in bed or roam through the house and prowl the kitchen. These people are not conscious during episodes of NS-RED. They are not aware they are eating. They have no memories of having done so when then wake, or they have only fragmentary memories. Episodes probably occur in a state somewhere between wakefulness and sleep. When people with NS-RED awake and discover the evidence of their nighttime forays, they are embarrassed, ashamed, and afraid they may be losing their minds. Some, when confronted with the evidence by family members, deny that they were the perpetrators. They truly do not believe they could have done such a thing and cannot admit to such dramatic loss of control. Food consumed during NS-RED episodes tends to be high-fat, high-sugar comfort food that people restrain themselves from eating while awake. Sometimes these folks eat bizarre combinations of food (hotdogs dipped in peanut butter, raw bacon smeared with mayonaise, etc.) or non-food items like soap they have sliced like they would slice cheese. One to three percent of the general population seems to be subject to this disorder, and ten to fifteen percent of people with eating disorders are affected. The problem may be chronic or appear once or twice and then disappear. Many of these people are severely stressed, anxious individuals who are dismayed and angry at themselves for their nocturnal loss of control. Many of these individuals diet during the day, which may leave them hungry and vulnerable to binge eating at night when their control is weakened by sleep. People with NS-RED sometimes have histories of alcoholism, drug abuse, and sleep disorders other than NS-RED like sleep walking, restless legs, and sleep apnea. Their sleep is fragmented, and they are often tired when they wake. Sleep disorders, including NS-RED, seem to run in families. They may have a genetic component It seems that parts of their brains are truly asleep, and, at the same time, other parts are awake. The parts that regulate waking consciousness are asleep, so the next day there are no memories of eating the night before. There is treatment. It begins with a clinical interview and a night or two at a sleep-disorders center where brain activity is monitored. Sometimes medication is helpful, but sleeping pills should be avoided. They can make matters worse by increasing confusion and clumsiness that can lead to injury. Regular use of sleeping pills can also lead to dependency and rebound wakefulness on withdrawal. Also helpful are interventions that reduce stress and anxiety; for example, stress management classes, assertiveness training, counseling, and reducing intake of alcohol, street drugs, and caffeine. |
| Night Eating Syndrome/ Nocturnal Sleep Related Eating Disorder |
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