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Título

INADEQUATE NOCTURNAL EATING BEHAVIORS: CAN NIGHT EATING SYNDROME AND SLEEP-RELATED EATING DISORDER COEXIST? CASE REPORT DESCRIPTION

Introdução

INTRODUCTION: A nocturnal eating behavior was described in 1955, when night
eating syndrome (NES), which is characterized by excessive food intake before going to bed
was reported. People with NES experience morning anorexia and difficulty falling asleep.
The circadian cycle of eating is possibly delayed and unlike people with a sleep-related eating
disorder (SRED), people with NES remember the events throughout the night. SRED is a
parasomnia with episodes of amnestic sleepwalking associated with eating behavior. These
events occur after a partial arousal from sleep, and the contend may be eat unusual food items
or atypical combinations. The main concerns with SRED are related to the safety during the
food preparation and the metabolic consequences.

Objetivo

OBJECTIVE: To present a case of two main types of inappropriate nocturnal eating
behaviors coexisting: nocturnal eating syndrome and sleep-related eating disorder.

Métodos

METHODS: Anamnesis and video-polysomnography (vPSG) were performed.

Resultados

RESULTS: We described a 56-year-old patient referred to our sleep medicine unit
reporting episodes of nocturnal eating behavior since she was in her early 20s. She
experiences nocturnal awakenings accompanied by an irresistible need to consume high
calorie snacks, which worsen in periods of greater anxiety. In most of these episodes, the
patient has full memory but eventually reports total or partial amnesia associated with
peculiar food intake.
The patient also complains of poor quality of sleep with significant daytime impact
(excessive sleepiness). The patient usually wakes up in the morning without appetite and
avoids high-calorie food during the day. As comorbidities, she presents diabetes,
hypertension, and anxiety, taking 80mg of fluoxetine and 300mg of bupropion per day. She
has been a smoker for 25 years and underwent bariatric surgery 20 years ago. She has a
history of childhood parasomnia unrelated to eating with remission of symptoms during
adolescence. The vPSG evaluation revealed reduction of sleep efficiency and an increase of
periodic leg movements (31,7/h) and microarousal index (10,4/h). The apnea-hypopnea index
was normal.

Conclusões

CONCLUSIONS: With this report, we draw attention to the possibility of the
coexistence of inadequate nocturnal eating behaviors and being able to identify
characteristics frequently associated with these patients.

Palavras -chave

KEY-WORDS: sleep-related eating disorder, parasomnias, eating disorder, sleepwalking,
night eating syndrome