Sleep eating: A behavioral food fight

Onset of syndrome usually comes in late teens, early 20s

Sleep eater Nancy Jordan "can go through a loaf of bread a night."

(CNN) -- Imagine waking in the morning with food smeared on your face and hands, or smashed into your sheets, or scattered around your kitchen.

A break-in? A prank?

No. Sleep eating. It's a rare but documented disorder.

Sleep eater Nancy Jordan of Wilmington, Delaware, says she's been sleep eating for more than 40 years. Her pattern of eating while in a sleep state may occur seven or eight times per night.

"I can go through a loaf of bread a night," says the 62-year-old mother of four adult children.

Jordan says she devours anything she can get her hands on during a sleep eating episode. "Peanut butter, I eat that [by] the spoonful. I've taken dry cereal to bed with me. Tomatoes out of the can. Margarine, that's my downfall. Pickles. Diet salad dressing. Frozen pizza, frozen chicken breasts and ice cream."

An estimated 1.5 percent of the United States population may be habitually eating during the night. But experts say that figure could also include people who are awake and aware of their odd-hours feeding habits.

Those who suffer true sleep-related eating aren't fully awake. "This is a partial arousal from sleep or a semi-sleep, a semi-awake state," according to Dr. Richard Waldhorn, medical director at Georgetown University Hospital's Sleep Disorder Center in Washington.

Experts say sleep eating is compulsive. Patients simply can't control themselves.

'Relates to sleep stages'

Dr. David Neubauer of Johns Hopkins Sleep Disorders Center in Baltimore, Maryland, has seen dozens of these patients. "They're so driven for this behavior, a lot of times they become rather belligerent in an uncharacteristic way if somebody tries to stop them from getting to food."

Most sleep eaters are female. "It comes on usually when they are in their later teens or early 20s and persists usually every night, sometimes for years, if not decades in many cases," says Dr. Neubauer. "And while people usually do it at least once nightly, some of them will do it several times each night."

Jordan says she's tried everything to stop sleep eating, short of tying herself to the bed. She's visited sleep disorder clinics, seen numerous doctors, taken sedatives. She has put kitchen chairs in the hallway between her bedroom and the kitchen. She has installed childproof gates in the doorway to the kitchen; she has put a bicycle lock on the refrigerator door and a lock on the pantry. But she still manages to get to the food and eat it, while she's asleep.

Like most sleep eaters, Jordan frequently doesn't recall her nocturnal consumption until she finds the evidence in the morning, or discovers food missing. The episodes usually begin within an hour after she falls asleep.

"Most people experience their very deepest sleep in the early part of the night usually within the first hour or so," says Neubauer.

"We believe that one primary cause (of sleep eating) relates to sleep stages. There is a spectrum of other kinds of unusual behaviors that people may exhibit during the night that tends to be associated with the deeper stages of sleep."

'Fires have started'

Typically sleep eaters consume high-fat, high-calorie or sugary foods. Some eat non-food items like cigarettes, cat food, household cleaning products.

According to Dr. Neubauer, "because people are sort of confused when they are doing this they may try to eat frozen food or even pick up other objects in their confusion and try to eat non-edible items."

For Jordan, it's pills. She keeps her prescription pills in a daily sorter case but sometimes pills are missing in the morning. "Some days they're not there and I know I've taken extra" during sleep.

"What gets really problematic is when people decide that they need to cook something and we've heard several episodes occurring where fires have started," says Dr. Neubauer.

Jordan says she has discovered that she's cooked pasta during sleep eating episodes, boiling water and burning up a pot a couple of times when she's wandered back to bed with the stove on.

Dr. Mark Mahowald, director of the Minnesota Regional Sleep Disorders Center, and Dr. Carlos Schneck of the department of psychiatry at the University of Minnesota Medical School -- both in Minneapolis -- were among the first medical professionals to define the disorder.

"In some cases there were apparent triggering events such as encephalitis, auto-immune hepatitis, narcolepsy, cessation of drug/alcohol abuse or smoking, or stress," write Mahowald and Schneck.

Sleep apnea or "restless legs" syndrome may also prompt sleep eating episodes. However, they note many patients don't seem to have experienced a definable trigger.

'Just don't go to sleep'

A number of treatments have been tried, including dopamine agents, anticonvulsion medications, antidepressants and opiates.

Jordan takes an anti-Parkinson's medication to help treat her sleep eating. But she says it has little effect.

"The only way I can cure it myself is just don't go to sleep," she says.

So Jordan never lies down for more than 15 minutes -- a strategy Johns Hopkins' Dr. Neubauer says could be fueling her nightly eating binge. "Make sure you're getting plenty of sleep because under circumstances of sleep deprivation, sometimes that makes it worse."

Jordan says it would be hard for her sleep experience to be much worse.