By R. Robert Auger, MD
Although they share similar features, there are important differences between nocturnal eating syndrome and sleep-related eating disorder, which can be elucidated with a careful history and evaluation. While the former is best characterized as an eating disorder with associated insomnia, the latter is classified as a parasomnia, and is frequently affiliated with other primary sleep disorders. Nonsomatic therapies in isolation do not appear to be helpful for either condition, but effective pharmacotherapies have been described for both entities. Beyond the obvious discouragement and social embarrassment conferred by both conditions, there are also significant potential medical comorbidities, predominantly in the form of refractory obesity and related complications.
When sleeping and eating behaviors are simultaneously affected, a fascinating spectrum of disease states may result. Nocturnal eating occurs in a variety of syndromes, but management can differ markedly, depending on the underlying etiology (Table 1). Nocturnal (night) eating syndrome (NES) and sleep-related eating disorder (SRED) will be the primary foci of this review. There is debate as to whether the two should be classified as independent entities or whether they should be considered as a continuum of a single condition involving eating urges and sleep disorders. This article will review the literature involving both topics and will strive to clarify nosologic and diagnostic ambiguities, with the ultimate goal of improving patient care.