Duration Between Arousal and Sleep-Related Eating Episodes
Sleep-related eating episodes occur immediately following arousal from sleep, with no significant lag time between the arousal and the onset of eating behavior.
Temporal Characteristics of Sleep-Related Eating Episodes
The transition from sleep to eating in SRED is essentially instantaneous:
Sleep-related eating disorder (SRED) is characterized by recurrent episodes of eating that occur "after an arousal from the main sleep period," indicating the eating begins immediately upon arousal 1
Episodes arise directly "at the transition from night-time sleep to arousal," with patients eating in an out-of-control manner as soon as they transition from the sleep state 2
The eating occurs "following arousals" from sleep, emphasizing the immediate temporal relationship between the arousal event and the eating behavior 3
Polysomnographic Documentation of Timing
Direct sleep laboratory observations confirm this immediate relationship:
In documented cases, sleep-related eating episodes arose directly from stage 2 Non-REM sleep, with eating beginning as the EEG transitioned to either remaining in stage 2 sleep or showing a wakeful EEG pattern 4
Polysomnographic studies identified that eating occurred from sleep with documented arousals, and the eating episodes themselves lasted a mean of 13.3 minutes once initiated 4
The original polysomnographic characterization noted that nocturnal, sleep-related eating occurred "from sleep," with the behavior emerging directly as patients transitioned out of the sleep state 5
Level of Consciousness During Episodes
The immediate nature of eating post-arousal is complicated by varying levels of awareness:
The level of consciousness during SRED episodes ranges from partial consciousness to dense unawareness typical of somnambulistic episodes, but the eating begins immediately regardless of consciousness level 2
Episodes occur with partial or complete amnesia for the event, indicating that even when eating begins immediately after arousal, patients may not be fully conscious 1
Clinical Implications
Understanding this immediate temporal relationship is important for diagnosis and management:
SRED is classified as an NREM-related parasomnia, and like other parasomnias such as sleepwalking (which occurred in 84.2% of SRED patients), the behavior emerges directly from the aroused state without delay 5
The immediate onset after arousal distinguishes SRED from night eating syndrome (NES), where eating occurs at full arousal from nocturnal sleep without accompanying amnesia 2