Saturday, November 13, 2010

Anorexia Nervosa Causes Nocturnal Sleep-Related Eating Disorder and Sleep Deprivation

Many people who have the eating disorder anorexia nervosa also may suffer from a nocturnal sleep-related eating disorder (NS-RED) in which they binge eat night after night. Individuals with NS-RED usually have trouble falling asleep easy and/or staying asleep during the night that can lead to chronic sleep deprivation. What is anorexia nervosa? Anorexia nervosa is commonly referred as anorexia, a psychological eating disorder. A person with anorexia often starts by dieting to lose weight, and then over time they become obsessed with becoming thinner. This obsessive compulsive behavior leads to an endless cycle of restrictive eating, exercising, using diet pills, diuretics, laxatives and/or enemas to reduce weight often to a point of starvation in order to feel a sense of control over their body. This cycle is similar to any type of addiction.

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95% of those affected with anorexia are female, but males can also develop this disorder. Anorexia on average starts during adolescence; it can also affect young children and adults. It has been reported that one in 100 adolescent girls have this disorder and middle to upper socioeconomic Caucasians are more susceptible than other racial backgrounds or lower social classes. The U.S. National Institute of Mental Health has estimated that .5%-3.7% of women will be diagnosed with anorexia at some point in their life time. Many experts believe those that are required to be thin for their profession such as athletes, models, dancers and actors are more at risk for eating disorders.

Medical and psychological professionals have not yet determined a definite cause of anorexia, however they continue to research possible causes. Studies suggest that there may be an inherited gene that may determine a person susceptibility to eating disorders. Other reports have identified a dysfunction in the brain’s hypothalamus or an imbalance in the brain’s chemicals that may contribute to the development of anorexia. If an individual has a history of under-eating, is a perfectionist, obsessive compulsive or has a negative body image may develop anorexia. Some believe an eating disorder may be a way or acting out or obtaining some control of their body if they have been a victim of child abuse. Child abuse can be contributed by what the parents believe someone’s body image should be by restricting the child’s food and putting emotional demands on the child to stay thin.

Night Eating Syndrome (NES) is a newly recognized eating disorder in which a person consumes more than half of their daily calories at night. Normally those with NES skip meals during the day and restrict calories due to guilt of over eating during the night. NES is different from binge eating because those with NES only over eat at night while binge eaters will eat large amounts of foods at different times of day. NES sufferers wake up during the night and desire high carbohydrates or high calorie foods in order to go back to sleep. Why carbohydrates and high calorie foods like sugar? These foods promote feeling of well-being and calms anxiety that helps them fall asleep.

One reason people have NES is that they are hiding this disorder just like anorexia from others due to shame or guilt. Over time NES can lead to chronic sleep deprivation that will decrease productivity during the day, impair memory, slow reflexes and eventually cause other medical or emotional issues like heart decease or depression. Abnormal hormone levels have been linked to NES like melatonin, leptin and cortisol. Melatonin is a hormone that helps people fall asleep easy and stay asleep as it controls the body’s sleep/wake cycle. Leptin, a hormone that suppresses appetite, lowers at night for those with NES. Since NES is associated with emotional distress, cortisol, a stress hormone is known to be elevated at night for those affected with this disorder.

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What is the difference between a person suffering from a night eating syndrome and those that have anorexia and a nocturnal sleep-related eating disorder (NS-RED)? NS-RED is not an eating problem per se; it is a sleep disorder associated with sleep walking that allows the person to eat while still asleep. The person is not conscious during NS-RED episodes and cannot recall eating the next day. The food consumed is most likely high caloric which is usually not eaten by those with anorexia. Since the person is unaware of what they are eating they may try odd combinations like raw bacon and mayo or even non-foods like soap. People with anorexia go to bed hungry at night and this is a way their body can take control of the calories it consumes in order to function. Is this possible? Research has shown that the brain can be awake and asleep at the same time.

There is treatment but it is necessary to correct the cause or anorexia before the NS-RED can be cured. An initial consultation and a night or two at a sleep center will determine if you are diagnosed with NS-RED. Sleeping pills should be avoided especially if they are dealing with a person that might become dependent, which over time and/or over use can also lead to insomnia. See: Sleeping Pill Addiction and Insomnia. An Ambien side effect  is sleep eating, sleep walking and sleep driving.  Alternative supplements may be introduced to help alleviate this condition like; melatonin or tryptophan to help a person sleep and GABA to reduce anxiety or stress.

An anorexic with NS-RED suffers from a vicious cycle of uncontrollable over eating during the night and starvation during the day, as they don’t know why they can’t lose the weight they desire. Other health issues associated with anorexia are disorders of the heart and circulatory systems, endocrine system, kidney function, electrolyte imbalance and anemia. Heart disease and an electrolyte imbalance can be fatal. Anorexia has one of the highest death rates of any mental health condition. Psychiatric counseling is the best choice for treatment of anorexia and early diagnosis and on-going therapy can cure about half of those affected. The ultimate goal in treatment is for the individual to lead a physically and emotionally healthy life through the development of self-acceptance.

It is important to be aware that throughout life, during positive and negative stress periods, people may experience eating and/or sleep disorders. If either or both of these conditions persist or interfere with daily life, then it is important to identify the underlying cause(s) of the problem. Problems with Eating and Sleeping are defined as usually over/under eating or too much or too little sleep. During the past decade, we have become aware of the detrimental effects of anorexia and compulsive overeating and while these problems may warrant medical attention, the underlying causes need to be identified and appropriate coping skills developed. The content provided in Anorexia Nervosa Causes Nocturnal Sleep-Related Eating Disorder and Sleep Deprivation is for information purposes only, intended to raise the awareness of different solutions for your sleep problems and should not be considered medical advice. For medical diagnosis and treatment, please see your qualified health-care professional.

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