title: Prevalence and clinical characteristics of unremembered nocturnal eating in diabetic subjects: Kurume sleep trouble in obesity and metabolic disorders (KUSTOMED) study.
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.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yamada
authors.forename: Hitomi
authors.initials: H
authors.lastname: Nakayama
authors.forename: Tomoko
authors.initials: T
authors.lastname: Kato
authors.forename: Yuji
authors.initials: Y
authors.lastname: Tajiri
authors.forename: Shuichi
authors.initials: S
authors.lastname: Sato
authors.forename: Saori
authors.initials: S
authors.lastname: Hirao
authors.forename: Tamami
authors.initials: T
authors.lastname: Oshige
authors.forename: Kento
authors.initials: K
authors.lastname: Hara
authors.forename: Shinpei
authors.initials: S
authors.lastname: Iwata
authors.forename: Naoka
authors.initials: N
authors.lastname: Kato
authors.forename: Yuko
authors.initials: Y
authors.lastname: Sasaki
authors.forename: Rika
authors.initials: R
authors.lastname: Hasuo
authors.forename: Satoko
authors.initials: S
authors.lastname: Yoshinobu
authors.forename: Kenshi
authors.initials: K
authors.lastname: Mitsuzaki
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Kato
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Hashinaga
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Muraishi
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Ohki
authors.forename: Hiroh
authors.initials: H
authors.lastname: Kaku
mesh_terms: D000328:Adult; D000368:Aged; D020324:Amnesia, Anterograde / Q000139:chemically induced / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D015992:Body Mass Index; D002940:Circadian Rhythm; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000097:blood / Q000139:chemically induced / Q000453:epidemiology* / Q000503:physiopathology; D001068:Feeding and Eating Disorders / Q000139:chemically induced / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology; D006963:Hyperphagia / Q000209:etiology; D006993:Hypnotics and Sedatives / Q000009:adverse effects; D007564:Japan / Q000453:epidemiology; D008297:Male; D008569:Memory Disorders / Q000139:chemically induced / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D008659:Metabolic Diseases / Q000150:complications; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D015995:Prevalence; D012893:Sleep Wake Disorders / Q000139:chemically induced / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology
chemical_list: D006442:Glycated Hemoglobin; D006993:Hypnotics and Sedatives; C517652:hemoglobin A1c protein, human