Sleep Eating Disorders - Treatment
Nocturnal Sleep-Related Eating Disorder (NS-RED) can be treated with life style modifications and medications.
Lifestyle changes that help to reduce the frequency of attacks are:
- Meticulous adherence to Sleep Hygiene Measures.
- Regular daytime eating schedules.
- Avoiding alcohol, street drugs, and caffeine.
- Overcoming stress by relaxation techniques and stress management.
Treatment with behavioral therapy is not always effective. Pharmacological agents such as dopamenergic agents or opioids in addition to effective stress management techniques, proper sleep hygiene, sleep schedule and a balanced diet are shown to be effective.
Sleeping pills are NOT recommended, since they are likely to cause even more confusion and this might lead to injury during episodes of NS-SED.
Treatment of Night Eating Syndrome (NES)
First it is important for the person to recognize that the behavior is not normal. A medical condition such as hypoglycemia can trigger sleep eating episodes.
Eating habits that need to be modified to conquer night eating syndrome (NES) are:
- The habit of eating in the middle of the night can be broken with behavior modification and/or stress reduction.
- It helps to consume small and frequent portions during the day.
- It also helps to minimize the consumption of carbohydrate and replace it with more protein during dinner.
- Sweets and snacks are taboo during dinner time or bedtime.
- Substitute with protein- rich diet at night as it metabolizes slowly and will stabilize blood sugar levels during sleep.
Those who have learnt to manage night eating problems have benefited and are able to sleep well without disturbance.
Drugs for management of NS-RED:
- Carbidopa/L-dopa combined with codeine.
- Carbidopa/L-dopa combined with codeine with the addition of clonazepam.
- Anticonvulsants, like Gabapentin or Topiramate.
- Fluoxetine as a monotherapy.
Other sleep disorders like Obstructive Sleep Apnea (OSA) that occur along with NS-RED need to be treated with Continuous Positive Airway Pressure (CPAP). Positive response to CPAP therapy with cessation of nocturnal eating behavior was noted in some patients.
Regular follow- up visits, with appropriate adjustment of medications, can help reduce the frequency of episodes of Nocturnal Sleep-Related Eating Disorder (NS-RED).
