Nocturnal eating: Sleep Related Eating D isorder & N ight E ating S yndrome

1. Nocturnal eating: Sleep Related Eating Disorder &Night Eating Syndrome NuFS 124 Group Members: Michele Franco Raquel Santillan Sabrina Garcia

2. Statistics • Both males and females are vulnerable to these disorders. It tends to occur more in adults, and in people under a great amount of stress or those experiencing anxiety. • About 4.6% of the general population experience sleep-related eating disorders (83% of that are women) • 10% to 15% of people with eating disorders are affected by sleep-related eating disorders • For some people, the problem is chronic, while for others it may happen only once or few times, then never again.

3. Etiology: Nocturnal Sleep Related Eating Disorder (NSRED) • Definition: An ongoing, persistent pattern of late night binge eating, while asleep. • There is no known definite or exact cause for abnormal sleep eating. • Some studies have suggested that it could be related to restless leg syndrome (RLS), for those who sleep walk. • RLS is believed to be related to abnormalities in brain chemicals (neurotransmitters), so NSRED might relate back to the brain as well. • History of alcohol or drug abuse, sleepwalking, RLS, or sleep apnea, and sometimes sleep aids (meds) can lead to NSRED.

4. Etiology:Night Eating Syndrome (NES) • Definition: An ongoing, persistent pattern of late night binge eating, while awake. • There is no an exact cause to abnormal sleep eating. • It could be due to poor nutritional eating habits (Eating high calorie comfort foods late at night) and having little to no appetite during the day. • Dieting • It could be due to poor sleeping habits as well, such as sleep apnea. • It may lead to insomnia, if not due to it.

5. Video Clip • http://youtu.be/4cFP4uoXlIw • http://youtu.be/WYdwhaJJmJE

6. Binge Eating

7. Psychopathology • “It is not a psychological problem, it is a major physiological force, coming from within your brain and body to eat at night so inappropriately”-Dr. Carlos Shank • In sleep walkers, the part of the brain the controls movement is awake, while other parts of the brain are asleep.

8. Pathophysiology • Gaining weight • Diabetes • Hypertension • High cholesterol • Eating nonfood items ex. glue, eggshells, coffee grounds, cleaning pads • Injuries such as cuts, falling down stairs which can result with broken bones

9. Diagnosis • Since no one knows what the definite cause of sleep eating is, a doctor may conduct a polysomnogram. A polysomnogram is an overnight sleep study that charts the brain waves, heart beat and my breathing as a person sleeps.

10. Symptoms & Risks

11. Treatmentof NSRED • Evaluationat a sleep disorder center. • Brain activity is monitored during sleep. • Help to identify sleep disorder. • Medications • Avoidance of sleeping pills. • SSRI: selective serotonin • reuptake inhibitors. • To treat stress, anxiety, and • depression.

12. Treatment NSRED Cont. • Reduction of stress and anxiety. • - Counseling • - Stress Management Classes • - Relaxation Techniques • Regular Exercise • Reduce alcohol and caffeine consumption. • Self-help Techniques

13. Treatment of NES • Medications • - SSRI selective serotonin reuptake inhibitors. • Nutrition Assessment • Weight Management • Reduction of stress and anxiety. • - Stress Management Classes • - Relaxation Techniques • - Regular Exercise

14. Treatment of NES • Therapy • -Cognitive Behavior Therapy (CBT) • -Dialectical Behavioral Therapy (DBT) • -Interpersonal Therapy (IT) • Progressive Muscle Relaxation* • -Tension and release of various • muscle groups. • Phototherapy* • -Exposure to daylight or wavelengths of light.

15. Treatment/Intervention It is very important for individuals with night eating syndrome to change their behavior by changing their beliefs. If they believe that they are powerless to change the way they eat, they will not be able to change.

16. Recovery People with symptoms of these disorders are often afraid or ashamed to seek treatment. However, with treatment the disorder can be controlled. Identifying and acknowledging the disorder or syndrome and knowing that it is not their fault can be an important first step toward recovery. Recovery requires careful planning and a team approach. For many patients, this means utilizing the full continuum of care. Typically, recovery takes place over years of mindful application of the lessons learned in treatment.

17. Q&A What are the differences between NSRED & NES? What are some similarities? 2. What are some of the potential health risks that can occur if someone has NSRED or NES? What are some physical risks that can happen to someone who has NSRED or NES? Which form requires a focus on therapy treatment, the syndrome or the disorder? Please state the therapies most commonly used in treatment.

18. References http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3616128/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3222864/ http://www.mirror-mirror.org/sleep-eating-disorder.htm http://www.waldenbehavioralcare.com/resources/popular-searches/night-eating-syndrome/ http://www.nami.org/ http://www.nationaleatingdisorders.org/recovery http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945843/ http://jama.jamanetwork.com/article.aspx?articleid=191250 http://onlinelibrary.wiley.com/doi/10.1111/j.2042-7158.2011.01353.x/full

19. References Continued • Nocturnal eating: Association with binge eating, obesity, and psychological distress • The international journal of eating disorders [0276-3478] Striegel Moore, Lynn yr:2009 vol:43 iss:6 pg:520 -526 • Review of nocturnal sleep‐related eating disorders The international journal of eating disorders [0276-3478] yr:1994 vol:15 iss:4 pg:343 -356