Prevalence and clinical characteristics of unremembered nocturnal eating in diabetic subjects: Kurume sleep trouble in obesity and metabolic disorders (KUSTOMED) study

Endocr J. 2013;60(9):1059-63. doi: 10.1507/endocrj.ej13-0098. Epub 2013 Jun 14.

Abstract

Nighttime food intake is associated with weight gain and higher HbA1c levels. We experienced night eaters who have no memory of their nocturnal eating in the morning. In this study, the curious night eating behavior was designated as "unremembered nocturnal eating syndrome (UNES)". We screened 1,169 patients with diabetes for sleep quality and abnormal eating behavior at night using the Pittsburgh Sleep Quality Index questionnaire with an additional question regarding UNES. When abnormal nocturnal eating behavior was noted, detailed clinical information was extracted from interviews with the patients. We identified 9 patients who experienced UNES. They had a higher BMI compared with subjects who reported no such episodes. Among them, 6 patients who consumed food at night without memory 2-5 times per month or more had significantly higher HbA1c levels. Continuous glucose monitoring in a patient with type 1 diabetes revealed an abrupt elevation of glucose levels from midnight when some foods were consumed. Eight of the 9 patients were taking benzodiazepine and/or non-benzodiazepine hypnotic agents when they experienced the episodes. The prevalence of UNES was 0.8% in all subjects and 4% in those taking hypnotic drugs. The ratio of hypnotic drug use in subjects with UNES was significantly higher than for individuals without UNES (89% vs. 17%, p<0.0001). Although UNES seems to be etiologically heterogeneous, hypnotics-induced parasomnia and/or anterograde amnesia may be associated with the behavior. UNES is not rare in diabetic patients on hypnotic medicine and may be a hidden cause of unexpected morning hyperglycemia.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Amnesia, Anterograde / chemically induced
  • Amnesia, Anterograde / complications
  • Amnesia, Anterograde / epidemiology
  • Amnesia, Anterograde / physiopathology
  • Body Mass Index
  • Circadian Rhythm
  • Cross-Sectional Studies
  • Diabetes Complications / blood
  • Diabetes Complications / chemically induced
  • Diabetes Complications / epidemiology*
  • Diabetes Complications / physiopathology
  • Feeding and Eating Disorders / chemically induced
  • Feeding and Eating Disorders / complications
  • Feeding and Eating Disorders / epidemiology*
  • Feeding and Eating Disorders / physiopathology
  • Female
  • Glycated Hemoglobin / analysis
  • Humans
  • Hyperglycemia / etiology
  • Hyperphagia / etiology
  • Hypnotics and Sedatives / adverse effects
  • Japan / epidemiology
  • Male
  • Memory Disorders / chemically induced
  • Memory Disorders / complications
  • Memory Disorders / epidemiology*
  • Memory Disorders / physiopathology
  • Metabolic Diseases / complications
  • Middle Aged
  • Obesity / complications
  • Prevalence
  • Sleep Wake Disorders / chemically induced
  • Sleep Wake Disorders / complications
  • Sleep Wake Disorders / epidemiology*
  • Sleep Wake Disorders / physiopathology

Substances

  • Glycated Hemoglobin A
  • Hypnotics and Sedatives
  • hemoglobin A1c protein, human