The human brain is truly a remarkable thing — and what it’s capable of doing while we’re asleep is perhaps the most remarkable thing of all. Sleep-eating, for example, can occur for a wide variety of reasons — and when it comes to the causes of sleep-eating, I’m willing to bet that there are a lot of things you don’t know about the condition.
Sleep-related eating disorder (SRED) — which is also sometimes referred to a nocturnal sleep-related eating disorder, or NSRED — isn’t terribly common; it only affects about one to three percent of the general population, according to online resource ANRED. What’s more, we haven’t been studying it for that long. The first documented report of nocturnal eating we have in the literature dates back to 1955 — and over the next several decades, only nine other reports, most of which were individual case studies, emerged. Doctors only seriously began studying it in 1985, when Mark Mahowald, MD, and Carlos Schenck, MD, began work on what would turn out to be the first major piece of research published on the condition.
Diagnosing SRED can be difficult due to the fact that, honestly, we still don’t know enough about it to have worked out a clear set of criteria. However, it’s typically characterized by episodes of eating or drinking that occur while the patient is still caught up in the sleep cycle; they may have “impaired consciousness while preparing and eating food,” according to the Mayo Clinic, and will have little to no memory of the events when they awake in the morning. Some SRED episodes might also involve the patient eating things that are not actually food. (According to Schenck and Mahowald’s research, one patient is on record as having eaten “buttered cigarettes” during an SRED episode.)
It’s worth noting, by the way, that SRED is not the same thing as night eating syndrome, or NES. According to an overview of SRED published in the journal Psychiatry in 2006, NES is classified as an eating disorder with associated initial insomnia, while SRED is classified as a sleep disorder, or parasomnia. There’s typically amnesia surrounding an episode of SRED — that is, people with it aren’t aware of what they’re doing — which isn’t the case for NES. This difference matters enormously when it comes to diagnosing and treating both conditions.
As for what causes SRED? Well, the bottom line is that we don’t really know (yet). We do, however, know about a number of things that are associated with it, which has given us clues and areas to explore as research about the condition continues. Treatment for SRED typically begins with a clinical interview, followed by a one- or two-night sleep study at a sleep facility, according to ANRED; from there, treatment will be tailored to individual patients.
Here are a few of things that we know are related in some way, shape, or form to SRED. If you think you might be experiencing the condition, make an appointment with your doctor, STAT — they should be able to refer you to a sleep specialist.
1. It Might Be Related To Your Gender
According to an overview of SRED and its associated conditions published in the journal Psychiatry and Clinical Neurosciences in 2015, SRED is more commonly found in women; they make up between 66 and 75 percent of all clinical cases. We don’t really know why that is — again, there’s a lot we don’t know about sleep-eating disorders — but it’s worth noting.
2. It Might Be Related To Your Age
According to that same overview from 2015, SRED tends to emerge in people who are in their late teens or early 20s. Typically it’s chronic, but as the overview notes, “There has been no conclusive information about whether all the affected persons exhibit a chronic course.”
3. It Might Run In The Family
A literature review focusing on both NES and SRED from 2006 noted that familial relationships have been observed in some SRED cases. So, if you have a family member who has dealt with sleep-eating, that might at least partially explain why you might be dealing with it, too: It could just be genetics.
4. If You Sleepwalk, It Might Have Something To Do With That
According to the Mayo Clinic, SRED frequently occurs in people who also have a history of sleepwalking, which means it’s possible that — if you both sleepwalk and sleep-eat — whatever’s responsible for your sleep-eating might be connected to whatever’s causing your sleepwalking.
Of course, that doesn’t really narrow the field much; sleepwalking can be caused by a wide variety of factors, including sleep deprivation, stress, fever, or other temporary sleep disruptions, or by something longer-term, like sleep-disordered breathing (sleep apnea, for example), substance use, or restless legs syndrome. If you have a pretty good idea of what causes your own sleepwalking, though, it might be worth running it by a doctor to see if they think it might also be a cause for your SRED.
5. It Might Be Related To Medications You’re Taking
According to the American Academy of Sleep Medicine’s online resource Sleep Education, SRED can “result from the use of certain medications,” particularly those used as treatment for other sleep issues or for depression. Indeed, a case study from 2013 found that sleep-eating was associated with zolpidem, a drug which is used to treat insomnia. The patient’s SRED ceased after the use of zolpidem was discontinued. What's more, an earlier study from 1991 by the same researchers also found that onset of SRED was connected to abuse of triazolam, another insomnia medication.
Again, if you think you’re experiencing SRED, check with your doctor about whether it could be related to any other medications you’re taking.
6. It Might Be Connected To Substance Abuse Withdrawal
According to a study from 1993 — one of the first serious studies done on SRED — the onset of sleep-related eating was found to be linked with both “abstinence from alcohol and opiate/cocaine abuse” and “cessation of cigarette smoking.” If you’ve recently quit using a particular substance and find you’ve developed sleep-eating habits, the two might be connected.
7. It Could Be A Stress Reaction
That same 1993 study also found onset of sleep-related eating to be associated with “acute stress involving reality-based concerns about the safety of family members or about relationship problems.” Stress management strategies and a good therapist might be worth looking into as part of a treatment plan in this case.
8. It Might Be Related To Another Health Issue
The 1991 study that found a connection between SRED and abuse of triazolam also noted that onset of SRED was “linked directly” with the onset of chronic autoimmune hepatitis — an inflammation of the liver that can result from your body’s immune system “turning against your liver cells,” according to the Mayo Clinic — and encephalitis, an inflammation in the brain typically caused by a viral infection. Other sleep disorders have also been noted in SRED patients. Chances are that if you're dealing with SRED, it's not an isolated issue.
If you think you might be experiencing SRED — or any other sleep disorder, for that matter — it's definitely worth finding a sleep specialist to help you get the diagnosis and treatment you need. The American Academy of Sleep Medicine's Sleep Education site can aid in locating an accredited sleep facility near you. Don't hesitate to reach out for help; everyone deserves to get a good night's sleep.