Grazing: The curious case of night munchies
On night-eating, Ambien, and sleep-related eating disorder
Seven months ago, I awoke at about 2 a.m. with my usual munchies and headed to the kitchen. Would it be sliced bananas tossed with warmed Nutella? A pint of ice cream, a protein bar, an apple? Maybe all of it. Yes! But the cupboard was bare.
Now, this gets a little complicated, but bear with me. It's important.
I was ravenous. "I'm going out to find something to eat," I announced to my partner Wayne.
The next thing I remember, three or four policemen were yelling at me to get out of my car. I was in the parking lot of the convenience store at the corner of Moreland and Euclid avenues in Little Five Points.
Then I went blank again. Later, I learned the cop in charge asked me what drugs I was on. I recited the list of pharmaceuticals I take daily to ward off the stroke that has killed so many in my family. I was also taking an over-the-counter cold remedy. And a couple more pills for this and that.
I told him I was really hungry. He asked me if there was someone I could call to come get me. I called Wayne but apparently talked gibberish and hung up. He called back and the policeman took the phone.
Wayne arrived and the policeman explained that they had received five calls that I was driving on the wrong side of DeKalb Avenue with my headlights off. Wayne, who later told me the policeman was one of the most compassionate people he'd ever met, put me in his car. That I wasn't arrested — or killed myself or others — is amazing. We drove home. I talked the entire time in a dream state. I was sleepwalking.
I remember almost none of this. The next morning, January 10, Wayne told me the full story and drove me to pick up my car. On the way home, I turned on my radio and, synchronistically, heard the explanation. That day, the FDA ordered the makers of the sleep drug Ambien and its generic varieties to cut doses in half for women and nearly in half for men.
I've been taking Ambien for seven years. It was first prescribed at Piedmont Hospital where I spent a week after emergency surgery on both my knees. Without the hypnotic drug, which is prescribed 60 million times annually, the terrible pain made sleep impossible. I took 15 milligrams, a high dose at the time, but it was lowered to 10 milligrams when I went home. I cut it to 5 milligrams after a few months and never stopped taking it after other events turned me into a complete insomniac.
I've had the late-night munchies all along. Usually, I remember them. There was, however, the day I woke up with a Nutella facial mask and amnesia. It's a well-known experience. Just last week, a friend told me he awoke that morning with his bed littered with M&M's. Another friend told me that he recently drove to a convenience store and piled Butterfingers on the counter. The clerk told him, "You were just in here buying the same thing." Years ago, a disabled friend blamed his 50-pound weight gain on Ambien-eating in his sleep. It happens. Often.
The official name for this is "sleep-related eating disorder." It was first identified in 2002. Successive research at, for example, the Mayo Clinic and the Minnesota Regional Sleep Disorders Center has verified the condition. But there's been no real explanation for it. Some postulate that Ambien causes a neurological hookup of the instincts to sleep and eat. Some theorize predisposal to the effect.
But it's not all about eating. I woke up one morning and discovered I'd ordered 15 shirts online, for example. (Thanks, Amazon, for the cancellation feature!) So, the drug seems for many to have a general disinhibiting effect that gets ramped way up by the drug. Thus, angry explosions are common, too.
The biggest danger, obviously, is driving either completely in one's sleep or significantly impaired the next day. That's the reason the FDA issued its order to reduce doses. It has received 700 complaints about Ambien-related driving problems over the years.
Of course, my experience disturbed me and I was in my doctor's office the next afternoon. He cited two things that may have made my experience particularly bad. I had increased my dose to 10 milligrams during my cold. The cold remedy I was taking too frequently included Dextromethorphan, a common ingredient that can be used recreationally to produce ketamine-like states. He theorizes that an interaction of the two drugs may explain my experience. Maybe.
My Ambien eating reminds me of my 20s, when I smoked a lot of hash and marijuana. I remember cooking all manner of concoctions on my contraband hotplate in my college dormitory room — mainly canned foods stirred together like slop for pigs. My roommate and I ate pounds of chocolate. And then there was the world-changing Cremora cobbler my first partner and I made one night.
As it happens, science has found a pretty good explanation for the marijuana munchies. It turns out that the active ingredient, THC, stimulates the same brain receptors that the taste of fatty food does. The brain then zaps receptors of the gut, our "second brain," and — boom! — you've got the voracious appetite of Godzilla. The finding emerged in a study of binge eating by Daniele Piomelli, a pharmacology professor at the University of California, Irvine.
An obvious difference is that weed-grazing is not necessarily associated with sleep and, as far as I know, doesn't occur during fully unconscious states. That means you get to have a fairly clear memory of your fucked-up meal.
That brings up another frightening thing about my Ambien episode. Because I was not there, so to speak, I did not have the full reaction of horror you'd have when consciously experiencing such an event. Friends tell me that I talked about it very matter-of-factly immediately afterward.
What to do? The big problem is that, as any insomniac can tell you, few drugs work as well as Ambien. I've tried them all. So as long as I am taking the drug, I've vowed to hide my keys and never increase my dose to 10 milligrams again. And, as God is my witness, I will never have a kitchen void of Nutella and apples again.