Chapter 37 Sleep-related eating disorder

Sleep-related eating disorder (SRED) combines features of sleep disorders and eating disorders, such that individuals have partial or complete arousal from sleep to eat. Patients with SRED generally arouse from sleep and eat roughly 2–3 hours after sleep onset. Eating episodes are characterized by rapid ingestion of food, which the patient usually reports as “out of control” or compulsive in nature. Both pharmacological and nonpharmacological treatments have been employed in SRED. Pharmacological treatments for SRED are divided into those that target underlying disorders thought to produce the abnormal nocturnal eating, and those empiric therapies that have been found, usually through serendipity, to be of therapeutic value. Those who report for clinical attention often have a chronic course, with multiple eating episodes per night, and a variety of daytime consequences of this behavior, including weight gain, daytime fatigue, and mood disorders. Currently, treatment is directed towards underlying sleep disorders, when present, or otherwise involves the empiric use of serotonergic antidepressants or topiramate.