What is Night Eating Syndrome?

What is Night Eating Syndrome?


Night-eating syndrome is an eating condition characterized by disturbed sleep. Night-eating syndrome leads people to wake up in the middle of the night to eat, which can lead to poor sleep quality and a variety of chronic health concerns, including cardiovascular attacks and diabetes. 

What is Night Eating Syndrome?

Night-eating syndrome refers to a condition in which a person consumes a significant amount of their daily food consumption at night. According to researchers, night eating syndrome affects about 1.5% of the population. The syndrome has symptoms with various mood, sleep, and eating disorders, but it is its distinct condition. Night eating syndrome affects 6% to 16% of obese adults, however, it is difficult to determine which disease causes the other. Night eating syndrome exists as a comorbidity with other disorders like depression, anxiety disorders, etc.

Symptoms Of Night Eating Syndrome

Possible signs of night eating syndrome include:

  • Consistently consuming at least 25% of daily calories after meals.
  • Getting up throughout the night to eat at least twice a week.
  • Being cognitively aware of night eating events and able to recollect them later
  • Skipping breakfast or feeling hesitant to eat in the morning, at least four times every week.
  • Constant Cravings to eat something even after  having meals at night
  • Having trouble falling or keeping asleep at least four evenings for a week in a row.
  • A misconception that eating is required to fall asleep.
  • Depressed mood, especially at night.
  • Experiencing anxiety or negatively impacting everyday functioning as a result of night eating episodes

What Are the Causes of Night Eating Syndrome?

Experts think night-eating syndrome develops when the body’s internal clock fails to align its sleep and feeding routines. Typically, varying levels of appetite-related hormones allow people to sleep through the night without the desire to eat. However, persons suffering from night eating syndrome may experience variations in hormones such as melatonin, leptin, ghrelin, and cortisol, all of which govern sleep, appetite, and stress.

A recent research discovered that nighttime individuals who like to sleep and wake up later were more likely to have night-eating syndrome. Other research discovered that persons with night-eating syndrome have a delayed release of melatonin. It is a hormone that promotes sleep. It is uncertain if the condition constitutes proof of a general delay in the body clock, or if eating at night may act as a cue to push the body clock later. Night eating syndrome does not appear to be more common in persons of specific genders, ages, or socioeconomic situations. However, it is more typically observed in patients with:

Other eating disorders, for instance 

Research indicates a substantial link between night eating syndrome and sadness or seasonal affective disorder (SAD). An individual might be more vulnerable to the Symptoms of night eating at times of heightened stress.

Is Night Eating Syndrome a genetic condition?

Some experts believe night eating syndrome may have a hereditary basis. Stress may cause low serotonin levels in genetically susceptible persons, resulting in a domino effect that disrupts the internal body clock and interferes with sensations of fullness. Some case studies and surveys have discovered that night eating syndrome may run in families, and researchers are beginning to pinpoint particular genes.  In a study conducted by Lamerz and colleagues, they discovered that children in Germany were more likely to acquire night eating syndrome if their moms ate at night. These patients were compared to children whose moms did not engage in night eating habits. A new research examined night eating practices in households with and without the disease. The findings revealed that people with NES had more first-degree relatives with the illness than the control group, indicating that the disorder is heritable.

How is Night Eating Syndrome diagnosed?

The Night Eating Questionnaire (NEQ) is a frequently used diagnostic instrument for night eating syndrome. The NEQ is a set of questions meant to determine whether a person’s feelings and behaviours are consistent with night eating syndrome. Questions cover six broad topics: morning hunger, breakfast timing, the proportion of calories consumed after supper, difficulty going asleep, overnight awakenings, and nocturnal eating episodes.

Another tool for diagnosing night eating syndrome is the Night Eating Symptom History and Inventory (NESHI), which is administered during a structured interview with a health care practitioner. Another questionnaire, the Night Eating Symptom Scale, may be used by physicians to assess progress for patients who have previously been diagnosed with night eating syndrome. A diagnosis of night eating syndrome may not require a person’s body weight to be lower or higher than average.

Night Eating Syndrome versus Binge Eating Disorder

According to studies, persons with binge eating disorder are more prone than those with night eating syndrome to be concerned about their eating habits, weight, or body shape, and to binge eat with a lack of control. Night eating syndrome, on the other hand, causes people to eat normal or modest portion amounts at night. While both illnesses are associated with sadness, depression and emotional eating appear to have a more significant role in binge eating disorder.

Night Eating Syndrome against Sleep-Related Eating Disorder.

On the surface, night eating syndrome may resemble a sleep-related eating disorder, which includes consuming significant amounts of food at night. However, someone with sleep-related eating disorder is not completely awake and can not recall these eating episodes, but someone with night eating syndrome is fully conscious when eating and can recall the incident later.

Differential Diagnosis

Night eating syndrome is mostly confused and often mistaken with sleep-related eating problems. The nature and components of nocturnal eating are the primary distinguishing features between NES and other sleep-related eating disorders. While the NES includes hyperphagia, nocturnal eating, and awareness, sleep-related eating disorders are distinguished by recurring uncontrollable feeding practices while sleeping. A sleep-related eating problem is classified as parasomnia because it involves involuntary and poorly remembered eating behaviours, as well as nonfood objects eaten, which are comparable to sleepwalking. Night eating syndrome is defined as insomnia where patients are awake, aware, and able to remember their eating habits. In general, people with NES do not report any underlying sleep difficulties. However, some people may describe both conditions.

Even while NES and binge eating disorder both exhibit evening hyperphagia, this does not imply that they have the same cause. Unlike binge eating disorder, evening hyperphagia in NES patients is mostly linked to nocturnal anxiety. Furthermore, people with NES consume less food in the evening (about 300Kcal) than those with binge eating disorders.

Treatments For Night Eating Syndrome

Experts are still deciding on the optimal treatment for night eating syndrome, although data shows that cognitive behavioural therapy combined with medication might be useful. The majority of drug research has concentrated on selective serotonin reuptake inhibitors.

Cognitive Behavior Therapy

The cognitive behavioural treatment (CBT)  in the case of night eating syndrome stresses more on unlearning the misconception. According to the source, one must eat before falling asleep. While working with a therapist, a person may record their beliefs and expectations, and then evaluate the validity of these views by observing what occurs when they do not eat before bedtime.

Therapy may also entail adjusting to eating a larger quantity of food earlier in the day. A therapist may also recommend maintaining a sleep and eating diary to help organize total food consumption and enhance sleeping patterns. It may be beneficial to exclude snackable items from the kitchen and bedroom, post encouraging notes on the fridge, or provide prizes for meeting goals. In addition to addressing night eating, a health care practitioner may advise on combining physical exercise and good sleep hygiene routines, such as establishing a consistent bedtime.

Bright Light Therapy

Researchers investigated morning bright light treatment and discovered that it improves mood, sleeplessness, and night eating symptoms, possibly by raising serotonin levels. Doctors might start working on the person’s depression before beginning alternative therapies for night eating syndrome.

Progressive Muscle Relaxation

Progressive muscle relaxation works by working across the body in stages, tensing one muscle group at a time and then releasing it before moving on to the next. This approach is commonly used to relieve tension and anxiety. According to preliminary research, gradual muscle relaxation may assist persons with night eating syndrome shift their hunger to the early hours and minimize negative emotions such as despair and worry

When to Consult Your Doctor

Eating at night on occasion may not be the reason for worry in and of itself, but you should consult your doctor if your food consumption or meal patterns are interfering with your health or quality of life. Night Eating Syndrome is a complicated illness that can have a substantial influence on a person’s physical and mental well-being.

Understanding the symptoms, causes, and current therapies for NES is critical to giving good care and support to individuals impacted by the illness. More studies into the underlying processes of NES and the development of focused therapies are required to improve outcomes for those suffering from this difficult eating disorder. To summarize, Night Eating Syndrome poses a unique combination of issues that necessitate a complete approach to diagnosis and therapy. We can increase our understanding of NES and the quality of care for people who suffer from it by raising awareness and funding research in this area.

 References +
  • Wikipedia contributors. (2024, February 21). Night eating syndrome. Wikipedia. https://en.wikipedia.org/wiki/Night_eating_syndrome
  • Salman, E. J., & Kabir, R. (2022, September 14). Night eating syndrome. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK585047/
  • Latzer, Y., Edelstein-Elkayam, R., Rabin, O., Alon, S., Givon, M., & Tzischinsky, O. (2024). The dark and comforting side of night eating: Women’s experiences of trauma. Psychiatry International, 5(1), 15–26. https://doi.org/10.3390/psychiatryint5010002
  • Pacheco, D., & Pacheco, D. (2024, April 22). Night eating syndrome: Symptoms, causes, and treatments. Sleep Foundation. https://www.sleepfoundation.org/nutrition/night-eating-syndrome

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