Treatment of Sleep-Related Eating Disorder

Giacomo Chiaro, Maria Turchese Caletti, Federica Provini

Research output: Contribution to journalArticle

Abstract

Sleep-related eating disorder (SRED) is classified as an NREM-related parasomnia characterized by recurrent episodes of dysfunctional eating that occur after an arousal from the main sleep period with partial or complete amnesia for the event, resulting in weight gain from eating high calorie foods and causing various injuries due to consumption of inedible or toxic items. SRED can be idiopathic or commonly associated with other primary sleep disorders such as sleepwalking, restless legs syndrome (RLS), obstructive sleep apnea syndrome (OSAS), other clinical conditions, or use of sedative-hypnotic medications. First-line treatment of idiopathic SRED includes selective serotonin reuptake inhibitors (SSRIs) at mean dosages of 20 to 30 mg/day. Topiramate at 100–300 mg/day and clonazepam at 0.5–2.0 mg/day can be valid alternative options. SRED related to other parasomnias or sleep disturbances that cause sleep fragmentation benefit most from treatment of the associated sleep disorder. In particular, RLS-related SRED is best treated with dopamine agonists such as pramipexole, while sleepwalking-related SRED benefits from low-dose benzodiazepines such as clonazepam. Different kinds of drug associations have been proposed in a limited number of cases, especially in the past. We strongly recommend that all patients suffering from SRED should undergo consistent and regular follow-up about 2–3 times per year or otherwise according to the physician’s judgment, in order to assess the evolution of symptom severity and frequency and re-evaluate treatment efficacy and any side effects that may arise.

Original languageEnglish
Article number33
Pages (from-to)1-11
Number of pages11
JournalCurrent Treatment Options in Neurology
Volume17
Issue number8
DOIs
Publication statusPublished - Aug 1 2015

Keywords

  • Night eating syndrome (NES)
  • Nocturnal eating
  • Parasomnia
  • Sleep-related eating disorder (SRED)
  • Sleepwalking

ASJC Scopus subject areas

  • Clinical Neurology

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