Clinical and Polysomnographic Features of Sleep-Related Eating Disorder
J Clin Psychiatry 1998;59:14-19
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Sleep-related eating disorder is a
recently described clinical syndrome that combines
characteristics of both eating and sleep disorders. Nocturnal
partial arousals are followed by rapid ingestion of food and
subsequent poor memory for the episode. Only two case series
examining this disorder have been published, and both are from
the same sleep disorders center in a general hospital.
Method: The author describes 23 consecutive
cases of sleep-related eating disorder that presented to the
Sleep Disorders Center at McLean Hospital. All patients were
administered a standardized clinical sleep disorders evaluation
followed by a semistructured interview to elicit information
regarding characteristics of sleep-related eating disorder.
Polysomnographic evaluation was performed on all patients with
clinical histories of sleep-related eating disorder.
Results: Eighty-three percent (N=19) of the 23
patients were female. For most of the patients, the disorder had
begun in adolescence (mean±SD=21.6±10.9 years) and had been
chronic, with a mean duration of 15.8±11.2 years. Nearly all
patients reported eating on a nightly basis (1_6 times per
night), and all episodes followed a period of sleep. All patients
described their eating as "out of control," and two
thirds stated that they "binged" during the night. Over
90% (21/23) reported their state at the time of nocturnal eating
as "half-awake, half-asleep" or "asleep," and
over 90% reported "consistent" or
"occasional" amnesia for the event. Nearly half (11/23)
of the sample were given a polysomnographic diagnosis of
somnambulism. Thirty-five percent (8/23) had a lifetime eating
Conclusion: Sleep-related eating disorder
appears to be a relatively homogeneous syndrome combining
features of somnambulism and daytime eating disorders. However,
no current nosology accurately characterizes these patients.
Physicians should be aware of the existence of the disorder and
the value of referring patients with sleep-related eating
disorder to a sleep disorders center.