Sleepwalking as a symptom of bulimia.

Abstract

mean duration of labour for primiparous women was less than six hours.7 Only 5% of the women had labours lasting longer than 10 hours. Afteractive management oflabour had been introduced their definition of prolonged labour was reduced from 36 hours to 12 hours. The prevalence of caesarean section varied from 4i00/o to 5-3%. The other components of active-management include the artficial rupturing of the membranes if labour does not progress according to a predetermined schedule and the use of intravenous oxytocin if the desired progress is not achieved by rupturing the membranes. These measures were used in 300/o of the cases. Although the effect of each of the three components has never been evaluated separately, the continuous support given by the midwife in this system could have effects similar to those observed in our two studies. We;can only speculate about the mechanisms by which social support reduces the duration oflabour and perinatal complications. Although the presence of a companion might account for the obstetrician making fewer interventions, it cannot also account for the reduced duration of labour. We favour explanations based on the effects the companion may have on-the mother.-Adrenaline is known to reduce uterine muscle contractions.' Lederman et al noted a correlation between plasma adrenaline concentrations and self reported anxiety.9 Increased concentrations of plasma adrenaline were associated with both anxiety and prolonged duration oflabour. By lessening anxiety in women in labour social support may prevent an increase in catecholamine concentrations and thus shorten the duration of labour. Studies in pregnant pigs and monkeys reveal that psychological stress can reduce uterine and placental blood flow and thereby fetal oxygenation.10 It By reducing the stress of labour social support mgt reduce the number of infants admitted for intensive care. If the results of this study can be replicated in other obstetric units in other hospitals present practices may be appreciably altered. This model may be useful in exploring the m'ech-; anss by which s'upport influences physiological processes.

Nighttime eating: A descriptive study

“…In addition, in our sample, parasomnias were significantly more frequent in participants meeting diagnostic criteria for a lifetime eating disorder. Several case reports and case series [35][36][37][38] have described patients who have a daytime eating disorder such as AN or BN and nocturnal eating without full awareness. Gupta 39 found that >30% of a group of patients with BN evidenced SRED.…”

Nocturnal eating: prevalence, features and night sleep among binge eating disorder and bulimia nervosa patients in Israel

“…Likewise, sleep disorders have been hypothesized to play a role in Nocturnal Eating Syndrome, although they have not been used for diagnostic purposes (Aronoff, Geliebter, Hashim, & Zammit, 1994;Guirguis, 1986;Nadel, 1981;Oswald & Adam, 1986;Schenck et al, 1991;Schenck & Mahowald, 1994). Few studies have been conducted with a large sample of patients, but various anecdotal cases have objectively confirmed the existence of Nocturnal Eating Syndrome as distinct from daytime eating disorders.…”

“…The same binge-eating episode may present during the night after sleep onset, and this behaviour may occur several times nightly. Some patients indicate full consciousness of their Nocturnal Eating Syndrome, while some indicate total amnesia (Guirguis, 1986;Gupta, 1991;Kavey, Whyte, Resor, & Gidro-Frank, 1990;Mancini & Aloe, 1994;Roper, 1989;Schenck et al, 1991;Schenck, Hurwitz, O'Connor, & Mahowald, 1993;Winkelman, 1998;Winkelman, Herzog, & Fava, 1999).…”

Naturalistic sleep monitoring in women suffering from bulimia nervosa

“…However, only a few cases of BN purging and nonpurging type that present nocturnal eating were reported in the literature. Guirguis (1986) reported on a case of nocturnal binging in a patient with nonpurging bulimia nervosa. Williamson, Lawson, Bennett, and Hinz (1989) reported a nightly binge eating episode in a patient with purging type BN.…”