Night Eating Syndrome

A health condition in which a person wakes up at night to eat is called night eating syndrome (NES). In some cases, it can be difficult to fall asleep unless your stomach is full. Therefore, these sleep disturbances may negatively affect your daily routine and mental health. To treat this condition, doctors often recommend dietary changes, rest, and therapies.

In other words, people with NES can wake up several times during the night to eat. For instance, a person can eat a large amount of food after dinner and before breakfast. While some people may eat at night occasionally, NES occurs when it happens every night. Moreover, NES is a type of eating disorder that often occurs along with a sleep disorder (insomnia).

In addition, when you wake up at night to eat, you may feel like you are not able to fall back to sleep if you are not full. Hence, it may affect your ability to perform daily activities. Those who leave NES untreated may develop some complications (such as an increased risk of obesity).

In general, this condition affects about 5 million people in the U.S.

Symptoms

Usually, people with NES feel ashamed, anxious, depressed, embarrassed, or exhausted. However, they may also experience the following symptoms. Examples include:

Waking up multiple times per night to eat (in some cases, more than 4 times per night)
People with NES often eat more than 25% of their daily food intake after dinner and before breakfast
Craving foods (usually, those that are high in calories, carbohydrates, or sugar)
Frequent skipping of breakfast or not eating the first meal until the afternoon
Persistent weakness and tiredness during daytime

If you experience any of the previous symptoms, it is advised to see a doctor for a diagnosis and treatment. Otherwise, it may lead to multiple health problems (including obesity).

Causes and Risk Factors

While experts do not fully understand why this condition occurs, some studies suggest that NES is associated with alterations in the circadian rhythm. It is a natural body “clock” that is responsible for regulating when you feel tired, alert, and hungry. In people with NES, this “clock” does not function properly, causing the body to release more hormones that stimulate hunger. Moreover, doctors have identified some factors that could increase your risk of developing NES. Examples include:

Genetics – This type of eating disorder may run in families. For instance, if you have a parent or sibling with NES, your risk of developing it significantly increases.
Stress – Usually, the symptoms worsen with stress, especially for long periods.
Daytime eating habits – Usually, people who do not get enough calories during the day may feel hungry and eat at night.
Obesity (excessive body weight)
Substance use disorder (SUD)
Mental health problems (such as anxiety and depression)
Other eating disorders (including bulimia nervosa, binge eating disorder, and others)

What Are The Potential Complications of Night Eating Syndrome?

Those who develop NES may also experience some complications, especially if they ignore the symptoms and do not get treatment. Check some of them below:

Weight gain and obesity – While obesity is a risk factor for NES, people with NES may also develop obesity if left untreated.
Metabolic disorders – These include type 2 diabetes, hypertension (high blood pressure), high cholesterol (hyperlipidemia), and insulin sensitivity.
Cardiovascular problems
Gastrointestinal (GI) issues (such as acid reflux)
Daytime fatigue – People with NES often feel tired and weak during their daily routine.
Mood disorders
Low self-esteem
Other eating disorders (such as bulimia nervosa)
Problems with relationships, family, or friends

This article does not contain a complete list of NES complications, but you can consult with your healthcare professional about ways to manage the symptoms and prevent the previous complications.

How to Prevent Night Eating Syndrome?

While it is not always possible to prevent this eating disorder, doctors may recommend the following tips to reduce the risk. For example:

Healthy foods – It is recommended to add in your diet more fresh fruits, vegetables, and whole grains to your diet instead of foods high in sugar and fat, and processed meats.
Good sleep hygiene – Avoid caffeine and electronics before bed and try to go to sleep at the same time each day.
Manage existing mental health problems – Doctors may recommend deep breathing and meditation to manage stress and counseling to manage anxiety or depression symptoms.
Physical activity – In general, it is advised to perform 30 minutes of physical activity per day, at least 5 days a week. It will also help to lose weight or prevent excessive body weight.

Diagnosis

Like the diagnosis of other conditions, it begins with a physical examination and questions about your symptoms and medical history. They may also keep a sleep diary, which helps doctors better understand their nighttime behaviors. Sometimes, you may also need an overnight sleep study to get more clues about your condition.

Treatment

In most cases, doctors recommend different treatments for people with NES. It depends on the severity of the condition, existing health problems, age, and preferences. However, they often prescribe one or a combination of the following treatment options. Examples include:

Cognitive behavioral therapy (CBT) – This is a type of psychotherapy (also known as talk therapy) that helps adopt healthier habits.
Antidepressants – This group of medicines is used to relieve symptoms of different mental health conditions. In such cases, doctors prescribe selective serotonin reuptake inhibitors (SSRIs) to boost your mood and regulate your emotions.
Progressive muscle relaxation – This is a way to relax the muscles and reduce stress.
Light therapy (also called phototherapy) – This treatment is used to adjust the circadian rhythm, which helps sleep better at night.
Melatonin – This is a specific hormone responsible for regulating the sleep-wake cycle. Sometimes, doctors may recommend melatonin supplements to ease the symptoms caused by NES.
Weight management program – Doctors may also help you keep a healthy weight and choose a nutritious diet.

In addition, doctors may also recommend hypnotherapy (also known as hypnosis) to treat NES. This is a type of mind and body treatment that can be used along with other NES treatments.

Frequently Asked Questions

When should I see a healthcare provider?

Commonly, you should visit a doctor if you suspect you may have NES or if you wake up multiple times at night to eat. Some people with NES may also have mental health conditions (such as anxiety or depression).

What is the outlook for night eating syndrome?

In most cases, people feel better with NES treatments and no longer experience symptoms. However, you should know that the treatment works gradually, and it does not happen overnight. If you develop a more severe form of NES or do not get treatment, it may lead to life-threatening complications. These include inability to perform daily tasks, hopelessness, and suicidal thoughts.

What is the cause of night eating?

This condition often occurs due to a combination of factors. These include changes in the circadian rhythm, hormonal imbalance, not getting enough calories during the day, sleep disorders, mood disturbances, and genetic factors. If you have any other questions, ask your healthcare provider.