Eating with eyes wide shut
Twenty-four-year-old Sheena Tripathi (name changed on request) had long outgrown her childhood habit of sleepwalking. However, when she shifted to a new city after a job change and began sharing an apartment with co-workers, she developed a new kind of parasomnia - eating in her sleep.
Her flatmates often heard her moving around the kitchen late at night, but it wasn’t till one of them walked in on her rummaging through the trash to eat discarded food while still seemingly unconscious, that they suggested she get professional help.
Dr Neerja Agarwal, the CEO and co-founder of mental health platform, Emoneeds, explains, “Her lack of memory of these episodes left her feeling helpless and frustrated.”
Fortunately, once the problem was diagnosed, the platform’s sleep specialist recommended cognitive behavioural therapy (CBT) and provided resources to improve Tripathi’s sleep hygiene, who was diagnosed with sleep-related eating disorder (SRED), a type of parasomnia or abnormal behaviour occurring during sleep. In it, the affected person involuntarily and repeatedly prepares and eats large quantities of food or consumes dangerous, even inedible items like coffee beans or cigarettes.
Often, there is no memory of the behaviour having occurred when they wake up the next morning.
“The reason behind this phenomenon is not fully understood but all types of parasomnias are caused by some disruption in regular sleep,” says Dr Divya Nallur, Clinical Director and Senior Consultant Psychiatrist at Amaha Health. “These abnormal behaviours usually occur when the person transitions between different stages of sleep. It can be explained as an event that takes place when the conscious brain is still asleep, but the part of the brain responsible for activity and body movements is awake.”
Though some people partially remember eating during their sleep, many don’t. They find out through someone sharing a living space, as in the case of Tripathi, or when they wake up to dirty plates in the kitchen.
Disrupted sleep patterns, often tied to other sleep disorders like insomnia, sleepwalking, or restless legs syndrome (RLS) could trigger SERD, as can certain kinds of medication like antidepressants. Emotional stress, anxiety, or a history of disordered eating can also increase the likelihood of developing it.
Dr Aggarwal recalls another patient who was steadily gaining weight without any apparent reason. When probed, he disclosed other unusual symptoms like unexplained bruises or cuts on his body, the feeling of fullness in the morning and excessive tiredness during the day. Her team recommended keeping a sleep diary and once SERD was confirmed, they offered more advice:
“We guided him to implement practical measures, such as locking kitchen cabinets at night for safety, and encouraged mindfulness techniques to manage stress. In just a few weeks, he experienced a noticeable reduction in episodes and began to feel more in control, leading to improved physical and emotional well-being.”
Certain medications have proved effective in treating SERD; however, it is difficult to prevent it from occurring. Creating calming bedtime rituals and limiting nighttime distractions may help curb episodes. And one should avoid taking sedative-hypnotic medication as it can trigger sleep-related parasomnia.