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Thursday, December 12, 2013
Eating disorder and sleep disorder
Hi my partner and I are in our late thirties. Since I can remember he starves all day and then eats before bed. This leads to him shouting and aggressive talk in the early hours (in his sleep). I have got him to try eating earlier and going to bed at 11pm with me and we have no problems. How can I get him to do this all the time as he keeps slipping back to his old habits. Some things he says in his sleep are very hurtful but he can never remember any of it.
Let me start out by saying that your partner’s eating habits do not appear to be consistent with a healthy lifestyle. If he truly is “starving” himself all day and only eating before bedtime, then he is likely to suffer significant health consequences down the road as a result of this irregular eating routine.
I am not aware of eating before bedtime as being reported as a risk factor for sleep talking. Having said that, it’s not out of the realm of possibilities that eating close to bedtime could be linked to sleep talking. Eating close to bedtime has been associated with night-time gastroesophageal reflux (GERD or heartburn) and GERD can lead to fragmented and poor sleep. It’s conceivable that either GERD or metabolic disturbances resulting from an irregular diet at night could lead to arousals from sleep that might make sleep talking more likely.
Sleep talking, also known as somniloquy, is not an uncommon problem, especially in children. While we don’t know exactly how common talking in sleep is, it is estimated to occur in about half of all children and in about 5% of adults.
Sleep talking can range from infrequent quite sounds to full spoken sentences to singing and shouting. Often, the speech cannot be understood and may sound like mutterings or gibberish. The cause of talking in sleep is not entirely known. Most of the time, the cause of this sleep behavior can not be linked to any identifiable underlying problem or disease. And in most cases, the problem is not serious and tends to resolve over time or with aging. However, in some cases, it has been found to be associated with other sleep-related disorders, such as sleep walking, REM behavior disorder (an unusual disorder in which individuals tend to act out their dreams while asleep), sleep-related epilepsy, post-traumatic stress disorder, sleep apnea, and the nighttime sleep eating syndrome (eating while asleep). In addition, in adults who begin sleep talking in adulthood (in other words, they did not do this as a child), there may be a higher rate of psychiatric disorders. However, most adults who talk in their sleep do not have these problems.
Often times, the most serious consequence of sleep talking is social embarrassment from unintentionally verbalizing subconscious thoughts or dream content. This may be the case in your situation, where your partner could be verbalizing his dream content. What exactly this means and how this relates to his awake experiences is unclear. Sometimes, sleep talking can cause disrupt sleep or the sleep of a bed partner. In this situation, further evaluation should be considered.
Since your partner’s sleep talking seems to resolve when he eats earlier in the evening, I would encourage him to do just that. It would be reasonable to let him know how his eating close to bedtime seems to lead to sleep talking, and you find this disruptive and hurtful. It would also be reasonable to inform him that eating close to bedtime is not in his best interest from a healthy lifestyle standpoint.
Good luck and here's to better sleep!
Dennis Auckley, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University