Objective:

To report the novel resolution of sleep-related eating disorder (SRED) in a patient with narcolepsy type 2 on sodium oxybate following treatment with a glucagon-like peptide-1 (GLP-1) receptor agonist.

Background:

SRED is a non-REM parasomnia characterized by recurrent episodes of eating during sleep and has been linked to dysregulation of sleep–arousal and appetite circuits. GLP-1 receptor agonists, such as tirzepatide, modulate hypothalamic satiety and mesolimbic reward pathways and have shown emerging benefit in impulse-control disorders such as binge eating. Their role in SRED, particularly among patients with narcolepsy, has not been previously reported.

Design/Methods:

A woman in her forties with a 15-year history of narcolepsy type 2 was managed with sodium oxybate, achieving adequate control of daytime sleepiness (Epworth Sleepiness Scale = 8). While on sodium oxybate, she developed SRED with nocturnal eating episodes occurring during sleep one to two times per month, followed by complete amnesia upon awakening. She was later initiated on tirzepatide, titrated to 10 mg weekly.

Results:

Following tirzepatide initiation, SRED episodes resolved completely and remained absent for over 12 months of follow-up. Brief recurrences occurred only during periods of delayed tirzepatide dosing. Sodium oxybate dosage remained unchanged, and no additional adverse effects were observed.

Conclusions:

In this patient with narcolepsy type 2 treated with sodium oxybate, initiation of tirzepatide was associated with sustained resolution of sleep-related eating disorder, suggesting a potential role for GLP-1 receptor agonists in managing this parasomnia. Modulation of hypothalamic and mesolimbic circuits may underlie this effect. However, further controlled studies are needed to validate this association and elucidate underlying mechanisms.