Sleep-related
eating disorder (SRED) is characterized by recurrent episodes of involuntary eating during sleep period and is often associated with
restless legs syndrome (RLS). Although
pharmacotherapy is recommended for SRED patients, no
drug have shown promising effects so far. The patient, a 48-year-old Japanese housewife, first visited our clinic and complained about nighttime eating. She had a history of
hypertension,
diabetes mellitus,
sleep apnea syndrome, and depression.
Insomnia appeared 10 years before the first visit and she often received hypnosedatives; at the same time, she developed nocturnal eating episodes. She had
amnesia for these episodes, and she felt urge to move her legs while sleeping. The patient was diagnosed with SRED and RLS. Reduction in the doses of
triazolam decreased her nighttime eating frequency, and her complete
amnesia changed to vague recall of eating during night.
Clonazepam 1.0 mg at bedtime decreased nocturnal eating frequency from 1 to 2 times per month, though
sleepwalking remained. Administration of
pramipexole 0.125 mg relieved all symptoms including SRED, RLS, and
sleepwalking. This is the first paper to report that the combination of
clonazepam and
pramipexole therapy-reduced SRED episodes and RLS symptoms.