Sleep-Related Eating Disorders

What is a sleep-related eating disorder?

Sleep-related eating disorder (SRED) is a type of parasomnia (abnormal behavior that happens during sleep). It causes you to prepare and eat food while you’re sleeping. When you wake up, you have little or no memory of what you did.

You probably found out that you’ve been sleep eating from someone who shares your living space. Or you woke up to dirty plates and silverware in the kitchen sink or peanut butter and jelly smeared all over the countertops. It’s common to feel confused about what happened at night, especially as you don’t remember it. It can seem like it was just a dream.

A healthcare provider can confirm that you’re not dreaming. In fact, sleep eating might be a side effect of certain medications or it could happen with other sleep disorders. You may hear your healthcare provider refer to sleep eating as a nocturnal sleep-related eating disorder (NS-RED).

It’s important to talk to a provider about sleep eating because it can be dangerous. It can lead to injuries like burns and cuts. You may even eat non-food substances that could be harmful or poisonous.

Treatment is available to address the cause. Your provider may also recommend lifestyle changes to improve your sleep.

What are the symptoms of a sleep-related eating disorder?

The symptoms of a sleep eating episode include:

• Sleep eating: You eat or drink a lot in a short amount of time (binge) while you’re sleeping. The food you choose is usually high in calories. In the morning, you may have a loss of appetite, feel full and choose to skip breakfast.
• Variable memory of episodes: If you have SRED, you probably have little or no memory of getting out of bed and eating, though some people have partial recall.
• Eating toxic or non-food substances: You may eat unusual food combinations that you wouldn’t put together while awake, or you may eat inedible or toxic substances. You might eat or drink things that aren’t food or that shouldn’t be eaten, such as coffee grounds, raw meat or cigarette butts.

When do sleep-eating episodes happen?

Sleep eating episodes can happen every once in a while or they can happen every night. They can also happen multiple times each night.

As a nonrapid eye movement (NREM) sleep disorder, sleep eating usually occurs during the first few hours of sleep in the NREM sleep stage. Episodes typically happen when you transition from one sleep cycle to the next.

Can you wake up someone who is sleep eating?

It’s difficult to wake someone up during a sleep-related eating disorder episode. It may appear as if the person is confused or in an altered state. If you can, gently try to safely guide them back to bed.

What causes a sleep-related eating disorder?

Experts aren’t sure exactly why sleep eating happens, but research shows the following factors may contribute to symptoms:

• An underlying medical condition (like encephalitis or hepatitis)
• An underlying mental health condition (like anxiety, depression, eating disorders, stress or substance use disorder)
• Changes to your routine (like quitting smoking or dieting)
• Medication side effects (sedative-hypnotics and benzodiazepines or benzodiazepine receptor agonists and some psychiatric drugs)

Sleep disorders that cause SRED

An underlying sleep disorder may cause SRED, including:

• Circadian rhythm sleep disorders
• Narcolepsy
• Periodic limb movement disorder
• Restless legs syndrome
• Sleep apnea
• Sleepwalking

These sleep disorders run in families. You may be more likely to have SRED if you or one of your biological family members has a sleep disorder.

What are the risk factors for a sleep-related eating disorder?

People assigned female at birth experience sleep eating more often than people assigned male at birth. Symptoms usually begin in your 20s and you may need to manage it throughout your life.

What are the complications of a sleep-related eating disorder?

Preparing and eating food while you’re sleeping can lead to:

• Physical injury (cutting or burning yourself)
• Food poisoning (eating raw food)
• Poisoning (consuming inedible products)

It’s also possible to put yourself and others in danger if you’re cooking food. For example, you may leave the stove’s gas on, set something flammable on a lit stove or set the oven on a high temperature. These could cause a fire.

You’re also at risk of other complications associated with sleep eating like:

• Weight gain
• Obesity
• Depression
• Daytime fatigue

How is a sleep-related eating disorder diagnosed?

To diagnose SRED, a healthcare provider will ask you about your symptoms during a physical exam. They may ask a family member, partner or roommate about your sleep habits, too, as you likely won’t remember sleep eating. The provider will examine you to see if a sleep disorder, health condition or medication you take might be causing symptoms.

To get more information about your sleep habits, they may ask you to keep a sleep diary for a few weeks. This is a record of when you go to bed, when you wake up, how you feel when you wake up and if, to your knowledge, you had any sleep eating episodes throughout the night.

Your provider may request a sleep study to get a better understanding of your sleep behaviors in a sleep center.

How is a sleep-related eating disorder treated?

Treatment varies based on what causes your symptoms. Your provider might recommend the following to treat sleep eating:

• Adding, stopping or changing certain medications you take (don’t make changes unless a healthcare provider approves it)
• Treating or managing any underlying medical conditions, mental health conditions or sleep disorders by taking medications or going to therapy
• Setting up safety measures by placing locks on refrigerators, cabinets or the oven — or putting an alarm on your bedroom door, and moving furniture and other hazards out of your path so you don’t fall

Your provider might recommend making lifestyle changes or improving your sleep hygiene to help you sleep better. These may include:

• Managing stress levels and practicing relaxation techniques, such as yoga and meditation
• Avoiding caffeine, screens and too much alcohol before bed
• Setting and sticking to a regular bedtime schedule

It can be difficult to make changes to your routine, even if it means you’ll sleep better. Try making one change at a time and mastering it before moving on to the next one. Your provider may have additional suggestions based on what you and your body need.

Medications for sleep-related eating disorders

Treatment for an SRED may include taking selective serotonin reuptake inhibitors (SSRIs). SSRIs are antidepressant medications that increase the levels of serotonin in your brain. Serotonin is a hormone that performs many different functions in your body, including regulating your mood.

Can a sleep-related eating disorder be prevented?

You can’t prevent all causes of sleep eating. But you can lower your risk of SRED by not taking sedatives to help you sleep. If you take antipsychotic drugs, ask your provider if that medication may cause SRED. They may offer alternative medications if you’re at risk of sleep eating.

What’s the outlook for sleep-related eating disorders?

With treatment, many people sleep eat less or stop the behavior over time. Treatment varies from person to person, so follow your healthcare provider’s treatment plan and instructions for the best results.

You can expect to see a healthcare provider a few times a year so they can monitor the effectiveness of your treatment and make adjustments to fit your lifestyle.

Untreated SRED may lead to injuries, food poisoning and illnesses. Sleep eating episodes will likely continue and may happen more often if you don’t seek care.

When should I see a healthcare provider?

See your provider right away if you suspect you’ve had episodes of sleep eating. A sleep-related eating disorder can be dangerous to your health and the health of those within your household, so don’t delay getting the care you need.

What questions should I ask my healthcare provider?

• What caused my symptoms?
• What lifestyle changes should I make?
• What treatment do you recommend?
• Are there side effects of the treatment?