Many people have heard of eating disorders such as anorexia nervosa or bulimia nervosa, but an eating disorder can present in many different ways. A lesser-known eating disorder is night eating syndrome (NES). Often overlooked or misunderstood by the general population, night eating syndrome affects about one in one hundred Americans, roughly a similar prevalence rate as anorexia nervosa. It’s important to understand the signs and symptoms so you or your loved ones can seek the support you may need. This article will highlight what night eating syndrome entails and explore six common symptoms of this complex disorder.
What is Night Eating Syndrome?
Night eating syndrome (NES) is a condition characterized by evening hyperphagia, or insatiable hunger and excessive eating in the evening, especially after dinner and during the night. Those who experience night eating syndrome consume a large amount of food post-dinner, often waking up in the middle of the night to eat 25% of their daily calories. This disorder disrupts normal sleep patterns, which impacts overall sleep quality. This in turn can cause daytime exhaustion, reduced concentration and memory, increased depression and anxiety, and weakened immune system response. Excessive food intake during fragmented sleeping hours can also trigger changes in circadian rhythm and hormone production. When left untreated, night eating syndrome can lead to chronic health problems and comorbidities such as diabetes and cardiovascular disease. Fortunately, this eating disorder is diagnosable and treatable by healthcare professionals. Read on to learn about some common symptoms of night eating syndrome.
6 Symptoms of Night Eating Syndrome
It is critical to recognize and understand the possible symptoms of night eating syndrome(NES) so you or your loved one can begin a path toward recovery. Here are six common symptoms of night eating syndrome:
1. Significant post-dinner eating
If you or a loved one tends to consume 25% of the daily caloric intake after the evening meal, you may be experiencing night eating syndrome. Those who experience night eating syndrome often have intense cravings in the evening or during the night. They might wake up from sleeping to binge on food or partake in excessive snacking late into the night. Often these practices are done in secrecy and may be hard to identify as they take place when other people in the household are asleep. It is often reported that nighttime overeating can co-occur with symptoms like restless leg syndrome and increased anxiety. Furthermore, night eating syndrome and binge eating disorder have similar symptoms, however night eating syndrome is defined by nighttime eating episodes.
2. Insomnia
Insomnia is when an individual has trouble falling asleep and staying asleep. This is a common condition, with nearly 30% of Americans reporting insomnia at some point in their lives. When an inability to sleep well is coupled with significant post-dinner eating, this may be a sign of night eating syndrome. Those who experience night eating syndrome may wake up in the middle of the night four to five times per week, many people reporting several nocturnal awakenings even within one night of sleep. Disrupted sleep can lead to exhaustion, difficulty concentrating, and changes in hormones that aid in digestion, mood, and other functions.
3. Suppressed morning appetite
When someone is experiencing night eating syndrome, they commonly display a diminished appetite in the morning, also known as “morning anorexia”. This is often due to the excessive consumption of food during the nighttime hours, as well as disruption of their circadian rhythm. When normal sleep cycles are disrupted this results in changes in appetite-related hormone production. When someone gets a full night of sleep, their body sends out signals in the morning to replenish its caloric reserves. If these signals are crossed due to night eating syndrome, this can look like a reduced appetite in the morning. Additionally, people experiencing night eating syndrome often sleep late in the morning to compensate for lost sleep during the night, meaning morning meals are often skipped.
4. Depression during evening hours
Mental health conditions like depression and anxiety are commonly associated with many kinds of eating disorders. Night eating syndrome is no different, with depression being a key symptom of this condition. Researchers have found that depression and seasonal affective disorder are closely linked to night eating syndrome. For those experiencing night eating syndrome , feelings of depression and low mood often increase during the evening hours. Patients often find themselves in a challenging depressive loop, where increased feelings of depression at night are temporarily soothed by nighttime eating, however the nighttime eating triggers further depressed mood and feelings of frustration, shame, and sadness. For those experiencing night eating syndrome, tackling depression, as well as the eating disorder, can be daunting, but these co-occurring conditions are treatable and manageable.
5. Belief that eating is crucial to fall asleep
Another symptom of night eating syndrome is when an individual believes they cannot fall asleep without eating. Habitual eating before bedtime or routinely eating to go back to sleep after awakening during the night are common for those who experience this eating disorder. These eating patterns are often linked to nighttime anxiety or depression. For some individuals, eating is a way to exert control over those feelings of nighttime anxiety and add to the complexity of night eating syndrome.
6. Daytime exhaustion and stress
When someone is experiencing night eating syndrome, their quality of sleep is greatly impacted by regular disruptions. This results in increased daytime fatigue and stress that can further exacerbate the impacts of the eating disorder. When the brain and body do not get adequate amounts of rest, regulation of bodily functions and mental faculties can be negatively affected.
This is not an exhaustive list of night eating syndrome symptoms and these symptoms could be indicators of other eating disorders and health conditions. Nevertheless, if you or someone you love is showing these symptoms, it may be time to talk with a healthcare professional and seek support.
Night Eating Syndrome vs. Sleep-Related Eating Disorder
Night eating disorder (NES) is often conflated or confused with sleep-related eating disorder (SRED). While many of the signs and symptoms look similar between these two eating disorders, there are clear and critical differences. To meet the diagnostic criteria of night eating syndrome, a patient must have an awareness of their nighttime eating behaviors and an ability to remember nocturnal eating episodes. Those experiencing sleep-related eating disorder (SRED) also consume food in the nighttime, however these patients cannot remember their nocturnal eating episode and are often unaware of this behavior. Both disorders pose serious risks to one’s health and both can be treated with the support of healthcare professionals.
Treatment Options
As with any disordered eating, treatment of night eating syndrome is available and recovery is possible. Treatment options may depend on many factors, such as medical or psychiatric (in)stability, availability of treatment facilities, and insurance coverage. The Night Eating Questionnaire (NEQ) is often used by healthcare professionals to diagnose this disorder.
The following are common treatment options for night eating syndrome.
Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT), is a common therapeutic intervention for many eating disorders and mental health conditions. When utilized to treat night eating syndrome, cognitive behavioral therapy may focus on helping patients unlearn their beliefs around eating in order to sleep. When this belief is dismantled, it begins the process of correcting the disruptions to sleep patterns, hormone regulation, and circadian rhythm. This night eating syndrome treatment option can be used in combination with sleep analysis and talk therapy to work toward recovery.
Light Therapy
Researchers have explored the possibility of treating night eating syndrome with phototherapy, or bright light therapy. Light therapy can be used to treat those who suffer from insomnia to help reset circadian rhythm and stimulate melatonin regulation by exposing patients to artificial light at particular times of day. Some case studies have shown that by treating the symptoms of insomnia commonly found in patients with night eating syndrome, the patient might reset the habit of waking during the night and thus reduce the occurrence of eating habits occurring during the nighttime.
Progressive Muscle Relaxation
Progressive muscle relaxation (PMR) is a practice wherein the patient tenses and relaxes one muscle group at a time, systematically working through the body until all muscle groups have been processed. Many people who struggle with restless leg syndrome, anxiety, and chronic stress use this technique to calm the body before sleep. Research shows that progressive muscle relaxation may reduce feelings of anxiety and depression, which can contribute to night eating syndrome.
The care team assigned to a patient may use these forms of treatments, as well as other therapeutic methods, psychiatry, and pharmacological interventions. Treating the mental health components with medications such as selective serotonin reuptake inhibitors, or SSRIs, can also help alleviate depression which commonly co-occurs with night eating syndrome. Working closely with healthcare professionals will ensure you find a safe and sustainable path to recovery.
Seek Help
If you or a loved one is experiencing night eating syndrome, or any of the signs and symptoms listed above, you are not alone. Recovery is possible and help is available with the National Alliance for Eating Disorders.