Snacking in Your Sleep? You Could Have a Sleep-Related Eating Disorder. Here's What to Know

Waking up in the night with a grumbling stomach gnawing at you is one of the worst ways to start your day. Perhaps instead, you've awakened in bed with a surprisingly full stomach and the remnants of a forgotten meal scattered about your blankets. Hunger at night can present various problems, and the ones you're faced with can depend on whether you struggle with parasomnia.

What is parasomnia?

At its core, parasomnia means you're partially asleep. It's also a broad category of sleep disorders that involve abnormal behaviors, experiences or physiological events that occur during sleep. These events often occur somewhere in that space between being fully asleep and being partially awake. Parasomnia can occur during REM or non-REM sleep and may present differently at these different stages of sleep. It can even involve eating in your sleep, but often not the best foods for sleep.

Children face significantly higher rates of parasomnia than adults, although it can affect people of all ages. Parasomnia's presentation can vary by type and circumstance, but it may include sleepwalking, night terrors, acting out dreams, thrashing and waking up in a confused and disoriented state.

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Parasomnias during REM sleep

• Nightmare disorder: This is characterized by vivid dreams that cause extreme feelings of fear or distress. A person may remember these dreams in detail if they're woken up and may have difficulty letting go of them and regaining a calmer state of body and mind.
• Recurrent isolated sleep paralysis:This is a form of sleep paralysis, which means a person can't move their body and limbs even if they awaken during this time. These sleep paralysis episodes generally last a few minutes or less but they can be disturbing. It can also be associated with other sleep disorders such as narcolepsy. 
• REM sleep behavior disorder: People with this disorder sometimes act out their dreams physically while sleeping, making sudden and potentially aggressive movements with their bodies and limbs. There may be a correlation between this disorder and several neurodegenerative diseases.

Parasomnias during Non-REM sleep

• Sleep terrors: People with sleep terrors may wake up suddenly in a terrified state, possibly screaming or crying out in alarm at the suddenness and intensity of terror. These episodes generally last less than a minute but can be longer.
• Sleepwalking: This disorder is characterized by people getting up and moving around while remaining asleep. Sleepwalkers may simply putter about the house clumsily, but they may also engage in more complex and dangerous activities despite being asleep.
• Confusional arousals: This condition involves appearing partially awake yet confused and disoriented. A person experiencing it may not know where they are or what's happening. They may speak and interact during these episodes but will do so slowly and with great confusion and difficulty.
• Sleep-related eating disorder: People with this disorder sometimes eat food while partially awake but mostly unaware and largely asleep. This can be unhealthy and even dangerous as the brain is not awake enough to avoid eating things it shouldn't, like uncooked meats. 

Is sleep-related eating disorder the same as night eating syndrome?

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These conditions are different at their core, although they can sound similar. Night eating syndrome is classified under eating disorders and involves waking up and feeling unable to go back to sleep unless you eat something. With this condition, people wake up fully and feel as if the only way they'll get back to sleep is if they eat something. This can happen frequently and up to multiple times per night but is not technically a sleep-eating disorder, as the individual is fully awake when eating. People who experience night-eating syndrome may benefit from learning about foods that sabotage their sleep.

In contrast, sleep-related eating disorder is classified under parasomnias and involves people eating food while mostly or completely asleep. Symptoms of this condition primarily include eating and drinking while sleeping, but this can, in turn, lead to other symptoms and health risks. There are two main types of sleep-related eating disorders. The first is drug-induced sleep-related eating disorder, which is caused by medications. The second is a primary sleep-related eating disorder, which occurs even without medications. These episodes typically occur during non-REM sleep, which is generally the first few hours of sleep. Several factors may increase your risk of experiencing sleep-related eating disorders, including if you already have restless leg syndrome, sleepwalking, narcolepsy, snoring, obstructive sleep apnea, high-stress levels, genetic predilection, an anxiety disorder, a depressive disorder or if you take certain medications.

Causes, diagnosis and treatment of sleep-related eating disorder

There are several possible causes and contributing factors for primary sleep-related eating disorders. While drug-induced sleep-related eating disorders are not always caused by medication, some sedative-hypnotics, such as zolpidem, are known to increase the risk of sleep-related eating disorders.

Beyond genetic predisposition, experts are uncertain of what causes primary sleep-related eating disorders. Still, they have noticed a strong correlation between the presence of this condition and the presence of sleepwalking, restless leg syndrome and narcolepsy. Some factors may also increase your short-term risk of experiencing such a condition, including snoring, sleep apnea, high stress, high anxiety, depression and eating disorders. And when it comes to sleeping, what you eat beforehand can have a significant impact on your quality of sleep.

Healthcare providers can diagnose sleep-related eating disorders by assessing your symptoms and potentially requesting that you either keep a sleep diary or stay on-site for a sleep study. These studies allow medical experts to monitor you as you sleep and can provide essential data on your condition and symptoms. For treatment and management, it's often recommended to mitigate stress levels through relaxation techniques, to practice good sleep hygiene, to create barriers at night between you and food and to arrange your furniture in such a way as to reduce the risk of late-night collisions. Treatment can also include cognitive behavioral therapy for insomnia, which can help reduce stress around sleep. You may even be able to aid your sleep by altering your diet.

The bottom line

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Sleep-related eating disorders can be disruptive, costly, unhealthy and dangerous. It can also be challenging to know if you are experiencing this since you're asleep when it happens. If you wake up to furniture rearranged and food items appearing in the middle of the night, you may want to speak with your doctor about a sleep disorder diagnosis. Even if you aren't concerned that you're eating in your sleep, if you see or suspect any symptoms of parasomnia in yourself or your loved ones, you should speak with a medical professional about sleep disorders.