Think you have a hard time losing weight? At least you’re not Lesley Cusack, a 55-year-old mother of three from Warrington, England, who suffers from a rare condition known as Sleep-Related Eating Disorder (SRED). Known commonly to the average person as “sleep eating,” SRED is a form of sleepwalking (or “somnambulism”) in which the sleeper doesn’t just walk around; he or she eats compulsively and then returns to sleep, awakening the next morning with no memory of the night before.
In Cusack’s case, she can consume up to 2,500 calories in one night of binging — more than the suggested daily caloric intake of 1,600 to 2,200 calories for a woman her age — which wreaks havoc with any plans she has for losing weight. “I can follow a diet to the letter,” she explains, “but it goes to pot at night.”
But calories should be the least of her worries, given she occasionally eats non-food substances that could be potentially poisonous, including Vaseline, paint, cough syrup and soap powder. After several years of suffering with the disorder, though, Cusack has come to accept it as part of her nightly routine: “The disturbed nights, waking up exhausted with stomach cramps, feeling sick and finding food bits in and around the bed is all part of what has become almost normal for me.”
The first case of SRED was reported in 1955, and over the next 36 years, only nine more occurrences were reported before the University of Minnesota Medical School undertook a study that uncovered 57 cases between 1991 and 1993. The study’s results aligned closely with Cusack’s case: two-thirds of the sleep eaters were women, their typical age was around 40 years old, they had been sleep eating for around 12 years, and 44% of them were overweight due to the disorder.
Since then, other studies have continued to identify specific characteristics and narrow the definition of SRED to the point where beyond simple involuntary nocturnal eating, someone must basically pose a danger to themselves in order to be diagnosed. Specifically, they must either 1) eat peculiar, inedible or toxic substances; or 2) engage in dangerous behavior while preparing food. Dangerous behavior includes cooking on an open flame, eating or drinking scalding hot foods/drinks and cutting food with sharp knives, while examples of inedible substances cited include egg shells, coffee beans, sunflower shells, buttered cigarettes, glue and cleaning solutions. Even edible food can be dangerous, however, such as foods to which the patients are allergic or thick foods like peanut butter that can be choking hazards.
There is no one agreed-upon cause of SRED, but it is often associated with some sort of psychiatric illness — usually a mood disorder — and other conditions that make sleeping difficult, such as sleepwalking, excessive snoring, restless legs syndrome and sleep apnea. Certain medications have been found to trigger sleep eating as well — primarily the sleep aid zolpidem (commonly known by the brand name Ambien) as well as sedatives and psychiatric drugs like lithium, triazolam, olanzapine and risperidone. An additional cause for SRED can be stress, with traumatic events such as a loved one’s death, divorce, stopping smoking and drug abuse cited as triggers.
Luckily for Cusack and other patients, SRED can be treated with medication, most notably the epileptic seizure prescription drug topiramate, which is known commonly as the migraine treatment Topamax. Additional treatments may include curing other associated sleep disorders, applying techniques for reducing stress and changing the sleep environment.
(Sources: The Telegraph, LiveStrong.com, National Institutes of Health, Current Psychiatry, Mayo Clinic, MedicineNet.com)