Abstract
In this paper, we present two carefully documented cases of patients with sleep-related eating disorder (SRED), a parasomnia which is characterized by involuntary compulsive eating during the night and whose pathophysiology is not known. Using video-polysomnography, a dream diary and psychometric examination, we found that both patients present elevated novelty seeking and increased reward sensitivity. In light of new evidence on the mesolimbic dopaminergic implication in compulsive eating disorders, our findings suggest a role of an active reward system during sleep in the manifestation of SRED.
Highlights
Two patients consulted our Sleep Laboratory for a nighttime eating behavior
SLEEP-RELATED EATING DISORDER According to the International Classification of Sleep Disorders (ICSD-2; American Academy of Sleep Medicine, 2005), sleep-related eating disorder (SRED) is a non-rapid-eye movement (NREM) sleep parasomnia characterized by recurrent episodes of involuntary compulsive eating during sleep, with morning anorexia and frequent comorbid sleep disorders [e.g., obstructive sleep apnea (OSA), restless legs syndrome (RLS), sleepwalking; as is the case of our two patients, who both have mild OSA and sleepwalking]
CONCLUDING REMARKS A recent study found that daytime personality traits correlate with the severity of insomnia, suggesting a link between individual daytime reward profile and sleep (Park et al, 2012)
Summary
Two patients consulted our Sleep Laboratory for a nighttime eating behavior. The first patient (patient A) was a 45-year-old obese (BMI 33.1) man who presented this behavior since 5 months. Apart from individual differences (Patient A showed low harm avoidance and behavioral inhibition scores and patient B demonstrated a elevated reward dependence score), both patients had elevated novelty seeking [with the exploratory excitability subscale (NS1) being increased] and self-transcendence on the TCI, increased experience seeking and boredom susceptibility in the SSSV, and reward responsiveness in the BIS/BAS scale, compared to population means (Table 2). Taken together, these findings suggest increased reward sensitivity and risk taking. Like for patient A, these dreams occurred during the nights patient B demonstrated his nighttime eating behavior
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