Restless nocturnal eating: a common feature of Willis-Ekbom Syndrome (RLS).
OBJECTIVE
To determine the frequency of nocturnal eating (NE) and sleep related eating disorder (SRED) in restless legs syndrome (RLS) versus psychophysiological insomnia (INS), and the relationship of these conditions with dopaminergic and sedative-hypnotic medications.


METHODS
Prospective case series.


METHODS
Sleep disorders center.


METHODS
Newly diagnosed RLS or INS.


METHODS
RLS or INS pharmacotherapy with systematic follow up interview for NE/SRED.


RESULTS
Patients presenting with RLS (n = 88) or INS (n = 42) were queried for the presence of NE and SRED. RLS patients described nocturnal eating (61%) and SRED (36%) more frequently than INS patients (12% and 0%; both p < 0.0001). These findings were not due to arousal frequency, as INS patients were more likely to have prolonged nightly awakenings (93%) than RLS patients (64%; p = 0.003). Among patients on sedative-hypnotics, amnestic SRED and sleepwalking were more common in the setting of RLS (80%) than INS (8%; p < 0.0001). Further, NE and SRED in RLS were not secondary to dopaminergic therapy, as RLS patients demonstrated a substantial drop (68% to 34%; p = 0.0026) in the frequency of NE after dopamine agents were initiated, and there were no cases of dopaminergic agents inducing novel NE or SRED.


CONCLUSIONS
NE is common in RLS and not due to frequent nocturnal awakenings or dopaminergic agents. Amnestic SRED occurs predominantly in the setting of RLS mistreatment with sedating agents. In light of previous reports, these findings suggest that nocturnal eating is a non-motor manifestation of RLS with several clinical implications discussed here.
Department of Neurology, Minnesota Regional Sleep Disorders Center and University of Minnesota Medical Center Sleep Disorders Center, University of Minnesota, Minneapolis, MN 55414, USA. howel020@umn.edu
Michael J
MJ
Howell
Carlos H
CH
Schenck
D001569:Benzodiazepines / Q000009:adverse effects; D015897:Comorbidity; D015259:Dopamine Agents / Q000009:adverse effects; D020920:Dyssomnias / Q000139:chemically induced / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011602:Psychophysiologic Disorders / Q000139:chemically induced / Q000453:epidemiology*; D012148:Restless Legs Syndrome / Q000139:chemically induced / Q000453:epidemiology*; D007319:Sleep Initiation and Maintenance Disorders / Q000139:chemically induced / Q000453:epidemiology*; D013577:Syndrome
D015259:Dopamine Agents; D006993:Hypnotics and Sedatives; D001569:Benzodiazepines