Psychiatry and Clinical Psychopharmacology

A case report of sleep related eating disorder that responded to trazodone

Psychiatry and Clinical Psychopharmacology 2013; 23: Supplement S282-S283
Read: 2377 Published: 17 March 2021

Circadian rhythms of eating and sleep often synchronized with each other in human. Abnormal eating during the main sleep period has been categorized as either night eating syndrome or sleep related eating disorder. Night eating syndrome (NES) is characterized by the clinical features of morning anorexia, evening hyperphagia, and insomnia with awakenings followed by nocturnal food ingestion. . Sleep-related eating disorder (SRED) is a heterogeneous syndrome as a separate day eating disorders has been identified in 1991. While the observed condition has been sharing many overlapping features with NES, it was distinguished by a preponderance of partial or complete amnesia for eating episodes. In this report, we present a case, who had SRED and whose symptoms were regressed with Trazodone 100 mg/day. A 35-year-old female was admitted to psychiatric clinic because of disruptive sleep, eating behavior during nocturnal sleep and daytime fatigue from the age of 31. The patient usually gets up to eat about 3 or 4 times every night as witnessed by her husband; however some days, she could not remember the night eating behavior, when she woke up in the morning. During episodes of SRED, she nearly caused a fire several times due to her smoking. In the morning, she usually felt nauseated with abdominal fullness and every day she lost appetite. She reported weight gain about 15 kg last four years. Prior to the onset of SRED, she was admitted to endocrinology because of hypoglycemia symptoms such as tremor, irritability and sweating. She had the diagnosis of reactive hypoglycemia and metformin treatment was initiated. But there has got no medical and psychiatric problem and normal blood glucose level measured right after wake ups at night for about 4 years. Polysomnography study indicated that she has insomnia and NREM behavioral disorder during episodes of SRED. Trazodone 100 mg/day treatment was initiated for provide integrity of sleep. One week after initiation of trazodone treatment, the frequency of arousals were reduced and sleeping time increased at about %25-50. Sleep-related eating disorder thought to represent a parasomnia and as such included within the revised International Classification of Sleep Disorders (ICSD-2) and characterized by nocturnal partial arousals associated with recurrent episodes of involuntary food consumption, altered levels of consciousness and tendency to dangerous behaviors during food preparation. The most common findingin polysomnography is multiple confusional arousals caused by slow-wave sleep. These arousal reactions may be associated with eating. However, abnormal awakenings may be due to all stages of NREM sleep or REM sleep, occasionally..

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