User login
MONTREAL – When night eating becomes pathological, with harmful effects on sleep and body weight, it is important to differentiate between sleep-related eating disorder and night-eating syndrome, said Dr. Jonathan Fleming, a psychiatrist at the University of British Columbia, Vancouver.
One key difference is that awareness of the awakenings and eating is seen in night-eating syndrome, but not in sleep-related eating disorder, he said at the annual conference of the Canadian Psychiatric Association. Another difference is that sleep-related eating disorder (SRED) is characterized by bizarre eating behavior, which can put the patient in danger.
“A recent patient of mine was found by his wife with the Christmas turkey, which was frozen, trying to carve it with a butter knife,” Dr. Fleming said. “People eat very unusual things–like raw meat–that they would not normally eat in the daytime. They can get up and drive in a confused state, and go pick up food from the store. Or they can cut or burn themselves trying to prepare something.”
Night-eating syndrome (NES) is considered largely an affective illness, but sleep-related eating disorder tends to be associated with sleep disorders–making the treatment of these conditions quite different, Dr. Fleming said.
“The major thought is that NES may be a variant of affective illness with an admixture of a circadian disorder, whereas SRED is particularly associated with sleep apnea and periodic limb movement disorder,” he said.
NES was first described in 1955, in patients seeking weight loss treatment. It occurs in about 1.5% of the population but is particularly prevalent in obese (6%–14%) and morbidly obese (42%) patients. It is characterized by evening hyperphagia, morning anorexia, initial insomnia, and awakenings throughout the night, with clear recall of being hungry and snacking.
There are no randomized controlled trials of treatments, but it is not surprising that case reports suggest chronobiotics (melatonin), antidepressants, appetite suppressants, and even light therapy have all been effective, he said. In contrast, night eating is involuntary and largely unremembered in SRED, and morning anorexia is often characterized by nausea resulting from the unusual foods or toxic substances consumed overnight. Because the underlying etiology is sleep disorder, this is where treatment of SRED is directed, Dr. Fleming said.
Dr. Fleming said he advises use of the parasomnia protocol for SRED patients, which can be remembered with the mnemonic SIS: Secure the bedroom and home environment; avoid intoxicant use; and keep the sleep schedule constant.
MONTREAL – When night eating becomes pathological, with harmful effects on sleep and body weight, it is important to differentiate between sleep-related eating disorder and night-eating syndrome, said Dr. Jonathan Fleming, a psychiatrist at the University of British Columbia, Vancouver.
One key difference is that awareness of the awakenings and eating is seen in night-eating syndrome, but not in sleep-related eating disorder, he said at the annual conference of the Canadian Psychiatric Association. Another difference is that sleep-related eating disorder (SRED) is characterized by bizarre eating behavior, which can put the patient in danger.
“A recent patient of mine was found by his wife with the Christmas turkey, which was frozen, trying to carve it with a butter knife,” Dr. Fleming said. “People eat very unusual things–like raw meat–that they would not normally eat in the daytime. They can get up and drive in a confused state, and go pick up food from the store. Or they can cut or burn themselves trying to prepare something.”
Night-eating syndrome (NES) is considered largely an affective illness, but sleep-related eating disorder tends to be associated with sleep disorders–making the treatment of these conditions quite different, Dr. Fleming said.
“The major thought is that NES may be a variant of affective illness with an admixture of a circadian disorder, whereas SRED is particularly associated with sleep apnea and periodic limb movement disorder,” he said.
NES was first described in 1955, in patients seeking weight loss treatment. It occurs in about 1.5% of the population but is particularly prevalent in obese (6%–14%) and morbidly obese (42%) patients. It is characterized by evening hyperphagia, morning anorexia, initial insomnia, and awakenings throughout the night, with clear recall of being hungry and snacking.
There are no randomized controlled trials of treatments, but it is not surprising that case reports suggest chronobiotics (melatonin), antidepressants, appetite suppressants, and even light therapy have all been effective, he said. In contrast, night eating is involuntary and largely unremembered in SRED, and morning anorexia is often characterized by nausea resulting from the unusual foods or toxic substances consumed overnight. Because the underlying etiology is sleep disorder, this is where treatment of SRED is directed, Dr. Fleming said.
Dr. Fleming said he advises use of the parasomnia protocol for SRED patients, which can be remembered with the mnemonic SIS: Secure the bedroom and home environment; avoid intoxicant use; and keep the sleep schedule constant.
MONTREAL – When night eating becomes pathological, with harmful effects on sleep and body weight, it is important to differentiate between sleep-related eating disorder and night-eating syndrome, said Dr. Jonathan Fleming, a psychiatrist at the University of British Columbia, Vancouver.
One key difference is that awareness of the awakenings and eating is seen in night-eating syndrome, but not in sleep-related eating disorder, he said at the annual conference of the Canadian Psychiatric Association. Another difference is that sleep-related eating disorder (SRED) is characterized by bizarre eating behavior, which can put the patient in danger.
“A recent patient of mine was found by his wife with the Christmas turkey, which was frozen, trying to carve it with a butter knife,” Dr. Fleming said. “People eat very unusual things–like raw meat–that they would not normally eat in the daytime. They can get up and drive in a confused state, and go pick up food from the store. Or they can cut or burn themselves trying to prepare something.”
Night-eating syndrome (NES) is considered largely an affective illness, but sleep-related eating disorder tends to be associated with sleep disorders–making the treatment of these conditions quite different, Dr. Fleming said.
“The major thought is that NES may be a variant of affective illness with an admixture of a circadian disorder, whereas SRED is particularly associated with sleep apnea and periodic limb movement disorder,” he said.
NES was first described in 1955, in patients seeking weight loss treatment. It occurs in about 1.5% of the population but is particularly prevalent in obese (6%–14%) and morbidly obese (42%) patients. It is characterized by evening hyperphagia, morning anorexia, initial insomnia, and awakenings throughout the night, with clear recall of being hungry and snacking.
There are no randomized controlled trials of treatments, but it is not surprising that case reports suggest chronobiotics (melatonin), antidepressants, appetite suppressants, and even light therapy have all been effective, he said. In contrast, night eating is involuntary and largely unremembered in SRED, and morning anorexia is often characterized by nausea resulting from the unusual foods or toxic substances consumed overnight. Because the underlying etiology is sleep disorder, this is where treatment of SRED is directed, Dr. Fleming said.
Dr. Fleming said he advises use of the parasomnia protocol for SRED patients, which can be remembered with the mnemonic SIS: Secure the bedroom and home environment; avoid intoxicant use; and keep the sleep schedule constant.