The affliction, known as nocturnal sleep-related eating disorder (NSRED), was first diagnosed in 1955, but the extent of the problem is only beginning to be understood, according to Lea Montgomery and colleagues from Baylor University and Texas Christian University in the US.

They urge nurses to be vigilant in their patient assessments so that they are able to spot people suffering from sleep-eating problems.

Ms Montgomery advises nurses to ask patients what time they go to bed, how long it takes to fall asleep, sleep duration and whether they have ever found unexplained food remnants in the kitchen when they wake up.

Such patients may not be hungry in the morning or may experience weight gain that is inconsistent with the amount of food they eat during the day.

One of the characteristics of condition is that patients eat “quickly and chaotically”, reports Ms Montgomery. She says they tend to pick foods containing fats and sugar and two of the most common foods chosen are pasta and peanut butter.

Experts speculate that stress, and low levels of melatonin and cortisol may play a part in NSRED. Also, conditions such as sleep apnea or restless legs syndrome might partially arouse the sufferer during non-rapid eye movement sleep, thereby prompting a “nocturnal eating episode”, said Ms Montgomery.

Some people with NSRED have even been known to eat cigarettes and cat food while suffering the condition, says Ms Montgomery, but this is unusual.

However, she explains that there is a stigma surrounding the disorder and patients are often “afraid to discuss” their problem.

The condition can be dangerous, with people cutting themselves on can openers, burning themselves with hot food or liquids or, in some cases, ingesting poison.

Some patients recognize the problem and take steps to prevent eating in their sleep, such as limiting the amount of food that they keep in the house or locking the refrigerator.

“These behavioral methods may help interrupt the behavior but do not address the underlying cause,” said Ms Montgomery.

She said appropriate treatments for NSRED include establishing a routine bedtime, taking regular exercise, losing weight if necessary, avoiding caffeine after lunch and sedatives and alcohol three to four hours before bedtime.

Source: RN, April 2002

© Health Media Ltd 2002
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