Case 21 - Gaining weight while asleep

Summary

This chapter presents the clinical history, examination, diagnosis, and the results of the procedures performed on a 27-year-old woman patient who was referred for evaluation of eating while asleep. Her tongue was scalloped and her hard palate was high-arched and narrow. The nasal examination was within normal limits. Cardiovascular, pulmonary, extremity and neurological examinations were within normal limits. The patient underwent diagnostic polysomnography (PSG). The patient also underwent a positive airway titration study, which showed that a continuous positive airway pressure (CPAP) setting of 8cmH2O effectively eliminated the obstructive breathing events and snoring. A diagnosis of sleep-related eating disorder (SRED) and obstructive sleep apnea (OSA) was made. This patient suffers from SRED, which is characterized by recurrent episodes of eating after an arousal from night-time sleep with negative consequences. Preliminary data suggest that SRED is a relatively common disorder and occurs more frequently in those with daytime eating disorders.