Schenck C H, Hurwitz T D, Bundlie S R, Mahowald M W
Minnesota Regional Sleep Disorders Center, Department of Psychiatry, Minneapolis 55415.
Sleep. 1991 Oct;14(5):419-31. doi: 10.1093/sleep/14.5.419.
Over a 5-yr period, 19 adults presented to our sleep disorders center with histories of involuntary, nocturnal, sleep-related eating that usually occurred with other problematic nocturnal behaviors. Mean age (+/- SD) at presentation was 37.4 (+/- 9.1) yr (range 18-54); 73.7% of the patients (n = 14) were female. Mean age of sleep-related eating onset was 24.7 (+/- 12.9) yr (range 5-44). Eating occurred from sleep nightly in 57.9% (n = 11) of patients. Chief complaints included excessive weight gain, concerns about choking while eating or about starting fires from cooking and sleep disruption. Extensive polysomnographic studies, clinical evaluations and treatment outcome data identified three etiologic categories for the sleep-related eating: (a) sleepwalking (SW), 84.2% (n = 16); (b) periodic movements of sleep (PMS), 10.5% (n = 2) and (c) triazolam abuse (0.75 mg hs), 5.3% (n = 1). DSM-III Axis 1 psychiatric disorders (affective, anxiety) were present in 47.4% (n = 9) of the patients, and only two patients had a daytime eating disorder (anorexia nervosa), each in remission for 3-7 yr. Nearly half of all patients fulfilled established criteria for being overweight, based on the body mass index. Onset of sleep-related eating was linked directly to the onset of SW, PMS, triazolam abuse, nicotine abstinence, chronic autoimmune hepatitis, narcolepsy, encephalitis or acute stress. In the SW group, 72.7% (8/11) of patients had nocturnal eating and other SW behavior suppressed by clonazepam (n = 7) and/or bromocriptine (n = 2) treatment. Both patients with PMS likewise responded to treatment with combinations of carbidopa/L-dopa, codeine and clonazepam. Thus, sleep-related eating disorders can generally be controlled with treatment of the underlying sleep disorder.
在5年的时间里，19名成年人到我们的睡眠障碍中心就诊，他们有非自愿的、夜间与睡眠相关的进食史，这种情况通常与其他夜间问题行为同时出现。就诊时的平均年龄（±标准差）为37.4（±9.1）岁（范围18 - 54岁）；73.7%的患者（n = 14）为女性。与睡眠相关的进食开始的平均年龄为24.7（±12.9）岁（范围5 - 44岁）。57.9%（n = 11）的患者每晚在睡眠中进食。主要症状包括体重过度增加、担心进食时窒息或烹饪引发火灾以及睡眠中断。广泛的多导睡眠图研究、临床评估和治疗结果数据确定了与睡眠相关进食的三种病因类别：（a）梦游（SW），84.2%（n = 16）；（b）睡眠周期性运动（PMS），10.5%（n = 2）；（c）三唑仑滥用（每晚0.75毫克），5.3%（n = 1）。47.4%（n = 9）的患者存在DSM - III轴I精神障碍（情感性、焦虑性），只有两名患者患有白天进食障碍（神经性厌食症），且均已缓解3 - 7年。根据体重指数，几乎一半的患者符合超重的既定标准。与睡眠相关的进食开始与SW、PMS、三唑仑滥用、戒烟、慢性自身免疫性肝炎、发作性睡病、脑炎或急性应激的开始直接相关。在SW组中，72.7%（8/11）的患者夜间进食和其他SW行为通过氯硝西泮（n = 7）和/或溴隐亭（n = 2）治疗得到抑制。两名PMS患者同样对卡比多巴/左旋多巴、可待因和氯硝西泮联合治疗有反应。因此，与睡眠相关的进食障碍通常可以通过治疗潜在的睡眠障碍得到控制。
