How Obesity Relates To Sleep Disorder

It is hard to imagine a life without food or one without sleep. After all, the body derives its energy from food; the energy is then used in carrying out the day to day activities of an individual. Once the body gets exhausted, it needs to sleep to regenerate and recover the lost energy.

In some situations, however, individuals develop certain disorders that affect either one or sometimes even both of these vital needs. Two primary diseases are related to sleeping and eating.

Furthermore, both of them are perfectly capable of causing weight gain and even obesity. The night eating syndrome (NES) and the nocturnal sleep-related eating disorder (NS-RED) are two closely related disorders that lead to abnormal eating habits and subsequently obesity.

Night Eating Syndrome (NES)

Also known as the nocturnal eating syndrome, this disorder was first described in 1955 in a study of 25 patients with refractory obesity. The study found that 64% of the participants (90% of whom were women) exhibited a combination of insomnia, nocturnal hyperphagia and morning anorexia.

More interestingly, this combination of different disorders had resulted in yet another disorder; one resulting in insomnia due to hunger. NES, therefore, describes a condition in which a person eats at night, while fully aware and also to trigger sleep. In essence, this means a person could eat as many times as he/she wakes up in the night.

Night Eating Syndrome

i. Prevalence

According to the National Institute of Mental Health, night eating syndrome affects at least 1.5% of the population. Some studies also suggest a prevalence of 12% in outpatient psychiatric patients while others have suggested an even higher prevalence of the condition among severely obese adults (approximately 27%).

ii. Causes Of NES

This hybrid sleep disorder is caused by some factors including;

A lifelong habit of eating late at night while in college may extend into life as an adult.

Stress and depression are also possible triggers of the condition particularly if the depression causes insomnia and overeating.

Some studies also indicate that the risk of contracting NES may soar if there is the history of it in the family.

iii. Symptoms Of NES

Nocturnal eating syndrome exhibits either of the following symptoms;

A person consumes more food after dinner than the food consumed at dinner.

A person consumes more than half of the daily food calorie intake after dinner. In the initial study of NES, the patients were getting at least 25% of their daily calorie intake from high-calorie meals consumed in the evening. More recent studies have however suggested that people with NES may consume more than 50% of their daily calorie intake between 8 pm and 6 am

People with NES may wake up several times in the night. However, because of the hunger stimulated insomnia, they find themselves needing to eat to get back to sleep.

As a result of eating more at night, people with NES often have little or no appetite at all in the morning.

iv. Effects Of NES

A distinct similarity between most people with NES is that they suffer from obesity. This may trigger weight-related problems such as an increased risk of heart diseases, gallbladder disease and certain types of cancer.

It is also possible for those diagnosed with NES to suffer from depression particularly if there is a history of substance abuse. Most people diagnosed with NES tend to have a preference for high-calorie carbohydrates which have bad cholesterol hence posing a significant health concern including high blood pressure and diabetes.

Nocturnal Sleep-Related Eating Disorder (NS-RED)

Popularly known as SRED, this condition was first described in 1991 in a study of 19 patients. Just like NES, this is also a hybrid of sleep disorder and an eating disorder. It is classified as a parasomnia which is a group of sleep disorders that trigger significant activities during sleep.

These activities may include talking while asleep, walking while asleep and in this case, eating while partially or fully asleep. The primary distinction between NES and SRED is that in SRED, people eat while asleep while in NES, people eat while fully conscious.

Nocturnal Sleep-Related Eating Disorder

i. Prevalence

SRED is more common than NES with research estimating that at up to 5% of the population have SRED. The prevalence increases among people with eating disorders ranging between 9% and 17% of individuals with eating disorders.

The American Sleep Association asserts that SRED is more common among women than men. Sleepwalkers and persons with other sleeping disorders are more likely to develop SRED.

ii. Causes

Some different factors are responsible for this sleeping disorder.

The use of certain drugs such as triazolam, olanzapine, and risperidone. It is also possible that the use of psychotropic drugs could increase the risk of developing SRED.

Genetics are also a possible cause of SRED particularly when there is a history of the condition in the family. According to research, between 5% and 26% of people diagnosed with SRED have a relative with SRED.

Sleep disorders such as sleepwalking, the restless legs syndrome and the movement of the periodic limbs of sleep among others. In fact, research estimates that up to 80% of SRED cases evolve from parasomnia disorders.

Stress and depression is also a possible trigger of SRED with studies estimating that up to 16% of SRED cases are triggered by stress.

Research has also established that in 37% of SRED cases, patients report having a prior psychiatric disease and 24% reporting prior substance abuse. Anxiety disorders trigger 18% of SRED cases.

iii. Symptoms Of SRED

Symptoms of SRED may include;

Waking up feeling exhausted and tired due to lack of adequate sleep.

Waking up with cuts and burns that weren’t there the previous night. Research suggests that up to a one-third of people with SRED report injuries from dangerous food preparation or consumption of dangerous objects.

The patient eats while in a diminished state of consciousness and sometimes even total unconsciousness.

Patients may even eat substances including cigarette butts, frozen foods, uncooked foods, high-calorie snacks, toxic substances and other inedible objects.

Patients may experience stomach pains and discomfort due to ingesting inappropriate substances.

Since people with SRED do not clean up; they leave dirty utensils, food crumbs, containers/dishes lying around. Patients may also start noticing that food is missing from the house.

iv. Effects of SRED

Firstly, SRED patients that also have food allergies and conditions such as diabetes face an increased risk of serious illness and an increased risk of death.

People with SRED may also consume unhealthy calories during this sleep eating episodes. Regular events of SRED may eventually lead to weight gain and obesity.

SRED increases the risk of contracting diseases such as high blood pressure, certain types of cancers

Treating Hybrid Sleep Disorders

Although there is no particular medication available for SRED and NES, certain combinations of antidepressants and anticonvulsant drugs help in reducing the prevalence of these sleep disorders.

Aside from that, experts have established that some therapies are useful in treating these two diseases. These include cognitive behavioral therapy, dialectical behavioral therapy, interpersonal therapy and stress management among others.

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