Once-Nightly Sodium Oxybate Shows Promising Results in SRED Treatment

In a notable advancement for the treatment of sleep-related eating disorder (SRED) among narcolepsy patients, a small-scale study presented during the 2025 SLEEP Annual Meeting revealed significant improvements following a switch to once-nightly sodium oxybate (Lumryz; Avadel Pharmaceuticals). The study, conducted by Dr. Lewis Kass, a pediatric pulmonologist at Valley Health System, included eight individuals who transitioned from twice-nightly sodium oxybate to the new formulation, with all participants experiencing resolution of SRED symptoms within six months. Notably, 63% of the subjects also reported a reduction in body mass index (BMI).

SRED is characterized by involuntary eating during partial arousals from sleep, often leading to memory lapses regarding the events. It is particularly prevalent among narcolepsy patients due to the disorder's inherent disruptions in sleep-wake regulation. The research highlights a critical intersection of sleep medicine and nutritional health, particularly as SRED can contribute to weight gain and related health complications.

The retrospective analysis demonstrated that before the switch, participants averaged 21 years of age, with 75% being female. The median duration of treatment with twice-nightly sodium oxybate prior to the switch was approximately 40.6 months. After transitioning to the once-nightly formulation, the median dosage increased slightly to 9 grams, indicating a tailored approach to optimize therapeutic outcomes.

"One of the biggest problems we deal with is sleep-related eating disorder, which is very common among these patients," stated Dr. Kass. This underscores the necessity for effective treatment options that address both narcolepsy and associated disorders like SRED. Prior to the introduction of once-nightly sodium oxybate in 2023, patients often struggled with managing hunger during the onset of sleep, leading to disruptive eating patterns at night.

The efficacy of once-nightly sodium oxybate stems from its approval based on data from the phase 3 REST-ON trial (NCT02720744), which demonstrated statistically significant improvements across multiple endpoints, including sleep latency and frequency of cataplexy attacks. Although there is a lack of large-scale clinical trials specifically targeting SRED in narcolepsy, existing literature suggests that other medications, such as topiramate and selective serotonin reuptake inhibitors (SSRIs), may also provide symptomatic relief.

Moreover, the World Health Organization's pharmacovigilance database lists sodium oxybate among medications associated with sleep-related eating disorders, highlighting the importance of careful patient management when prescribing such treatments.

As narcolepsy and its associated disorders gain increased attention within the medical community, ongoing research will be essential to establish comprehensive treatment strategies that effectively address the multifaceted challenges faced by patients. The promising results of this small-scale study pave the way for further investigation into the broader implications of once-nightly sodium oxybate for sleep disorders, potentially transforming the landscape of treatment options available for individuals suffering from SRED and narcolepsy.