Sleep-related eating disorder (SRED) is a parasomnia that arises primarily from NREM sleep with recurrent episodes of involuntary eating and drinking. This chapter discusses the case of a 32-year-old woman who presented with sleep-related eating episodes, who also had difficulty with sleep initiation insomnia, somnambulism, somniloquy and symptoms of restless legs syndrome (RLS) since she was 6 years old. It presents the clinical history, examination, follow-up, treatment, diagnosis, and the results of the procedures performed on the patient. Overnight diagnostic polysomnography (PSG) was performed. Based on the PSG results, a diagnosis of SRED was made. Complications include obesity, injuries, toxic ingestions and psychological distress with excessive weight gain. Treatment of the underlying sleep disorder, if present, is usually effective. Underlying mood disorder or alcohol or substance abuse should be addressed. Pharmacotherapy consists of administration of antidepressants (e.g. SSRIs), dopaminergic agonists or topiramate.

This chapter discusses the case of a 43-year-old male having problems with his nocturnal sleep at the age of 23 when he started to present recurrent nocturnal awakenings from sleep associated with involuntary eating. It presents the clinical history, examination, follow-up, treatment, diagnosis, and the results of the procedures performed on the patient. Actigraphic recordings for 2 weeks disclosed persistent muscular activity during the nocturnal period and two to five episodes per night of further enhanced muscular activity that corresponded to the eating episodes noted by the patient in his diary. The sleep medicine specialist established a diagnosis of sleep-related eating disorder (SRED) based on the clinical history and on the results of the video-polysomnography (PSG) recording. Low-dosage dopaminergic agents such as levodopa/carbidopa at bedtime, sometimes combined with codeine and/or clonazepam, bromocriptine and pramipexole, have been shown to reduce the eating episodes.

This chapter presents the clinical history, examination, diagnosis, and the results of the procedures performed on a 27-year-old woman patient who was referred for evaluation of eating while asleep. Her tongue was scalloped and her hard palate was high-arched and narrow. The nasal examination was within normal limits. Cardiovascular, pulmonary, extremity and neurological examinations were within normal limits. The patient underwent diagnostic polysomnography (PSG). The patient also underwent a positive airway titration study, which showed that a continuous positive airway pressure (CPAP) setting of 8cmH2O effectively eliminated the obstructive breathing events and snoring. A diagnosis of sleep-related eating disorder (SRED) and obstructive sleep apnea (OSA) was made. This patient suffers from SRED, which is characterized by recurrent episodes of eating after an arousal from night-time sleep with negative consequences. Preliminary data suggest that SRED is a relatively common disorder and occurs more frequently in those with daytime eating disorders.

Sleepwalking is not the only NREM parasomnia that has been observed to be associated with medication or substance. It is, however, the most common group, the one most familiar to psychiatrists, who noted this as a side effect following initiation or escalation of some medications used for treating their patients, particularly those with bipolar depression in manic episodes, schizoaffective patients and anxiety patients with insomnia. This chapter covers the published reports in which sleepwalking event occurred closely following the initiation of medication and its resolution on withdrawal from the drug. The anti-depressant medications and their effects on sleep, few studies give the effects on slow-wave sleep (SWS). The benzodiazepine that has been most clearly associated with sleep-related eating disorder (SRED) is triazolam, although it is associated with initiation of several other NREM parasomnias.