Waking up and eating: Night Eating Syndrome: Symptoms, Causes, and Treatments
Nocturnal Eating Sleep Disorders – Sleep Center
Sure, everyone likes a good bedtime snack, but for some people, nighttime eating stretches beyond that final bowl of ice cream before turning in. These people find themselves inadvertently snacking the night away, either knowing or unknowingly, in the form of nocturnal eating disorders, or NEDs.
There are two types of these eating disorders, nocturnal eating syndrome (NES) and sleep-related eating disorder (SRED). The main difference between the two sleep disorders is that during NES, the person is fully aware of their actions, but with SRED, the person only partially wakes up and then unknowingly begins sleep eating. Between 1 and 3 percent of the general population is thought to have one of these nocturnal eating disorders, which are considered both an eating disorder and a sleep disorder.
People with NES will wake up during the night and have an uncontrollable urge to eat, regardless of how hungry they are. In fact, many people with NES are unable to fall back to sleep unless they eat.
People with SRED partially awaken in the middle of the night in a situation similar to sleepwalking and other sleep disorders, and then start sleep-eating, which normally entails unconsciously eating a large amount of typically unhealthy, high-calorie foods. Unlike NES, during which people remember their nighttime eating, those with SRED may not remember sleep eating or may only partially recall the event in the morning. Many times, when they find their kitchen a mess the next morning, they have no idea how it got that way.
Nocturnal eating disorders, if left untreated, can lead to significant weight gain and other health problems, such as type 2 diabetes, hypertension, and depression. “If you suspect you have a nighttime eating disorder, speak with your doctor,” said David Schulman, MD, MPH, chief of pulmonary and critical care medicine at Emory University Hospital in Atlanta.
The Causes Behind Nocturnal Eating Disorders
Sleep eating disorders are seen in both children and adults. They are more common in women, as most eating disorders are, and occur more often in people under the age of 50. Nocturnal eating disorders can be the result of an underlying medical problem, such as stomach ulcers, sleep apnea, or depression, other eating disorders such as bulimia, other sleep disorders such as sleepwalking, or a traumatic event. Zolpidem (Ambien), a prescription sleep aid, may also cause nighttime eating.
In addition, SRED can affect people who are on diets or who are under a large amount of stress. They may go to bed hungry because of their restricted diet and then unconsciously eat at night.
The Signs of Nocturnal Eating Disorders
If you exhibit the following behaviors for at least two months, you may have nocturnal eating syndrome:
- You frequently wake at night and feel that you must eat in order to go back to sleep.
- You eat more food after dinner than during dinner — more than half of your daily food intake comes after dinner.
- You have little or no appetite for breakfast.
Symptoms of sleep-related eating disorder may include:
- Seeing evidence of nocturnal eating when you get up in the morning, such as food left out on a counter or a disheveled kitchen
- Having little or no appetite in the morning
- Experiencing significant weight gain
Treating Nocturnal Eating Disorders
If you suspect that you have a nocturnal eating disorder, talk to your doctor about getting a full health evaluation to rule out other conditions that may be causing the symptoms. A sleep study may be recommended to detect unusual sleep behaviors.
Once an accurate diagnosis is made, medications may be prescribed to treat nocturnal eating. Topiramate (Topamax) is an anti-seizure medication that can be used to treat both NES and SRED. “It works on the appetite center of the brain to dull it a little,” explains Dr. Schulman. “It also helps with weight loss.”
If depression is causing your nighttime eating, an antidepressant may be prescribed along with counseling and support. In addition to drug treatment, minimizing alcohol consumption, which can disrupt sleep, and reducing stress may help prevent nocturnal eating.
If you think you may have a nocturnal eating disorder, take steps to get help. Nocturnal eating “is a medical disorder that can be treated,” says Schulman. “If you suspect you have it, talk to your doctor.”
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What Is Night Eating Syndrome?
Written by David Steen Martin
- What Causes It?
- Genetic Reasons?
- How Is It Diagnosed?
- Health Effects
Night eating syndrome (NES) is a condition that combines overeating at night with sleep problems. With NES, you eat a lot after dinner, have trouble sleeping, and eat when you wake up at night.
If you have NES, you eat at least a quarter of your daily calories after dinner. That fact also bothers you.
If that’s you, and you wake up to eat at least twice a week, you may have NES if you also have at least three of these:
- Lack of appetite in the morning
- A strong urge to eat between dinner and sleep
- Insomnia four or five nights a week
- A belief that eating is necessary to get to sleep or get back to sleep
- A depressed mood that gets worse during evening hours
Night eating syndrome is different from binge eating disorder. With BED, you’re more likely to eat a lot at a single sitting. If you have NES, it’s likely that you eat smaller amounts throughout the night.
NES is also different from sleep-related eating disorder. With NES, you’ll remember that you’ve eaten the night before.
It’s not clear. Doctors think it might be related to issues with the sleep-wake cycle and some hormones. Changes in your sleep schedule and routines aren’t responsible.
You’re more likely to have night eating syndrome if you’re obese or have another eating disorder. A history of depression, anxiety, and substance abuse are more common in people with NES.
NES affects a little more than 1 in 100 people. If you’re obese, there’s about a 1 in 10 chance you have it.
Researchers have found a possible link between NES and genetics. There’s a gene called PER1 that’s thought to have a hand in controlling your body clock. Scientists believe a defect in the gene could cause NES. More research is needed.
Your doctor will diagnose night eating syndrome after asking you questions about your sleep and eating habits. This could include a detailed questionnaire. You may also have a sleep test called polysomnography. It measures your:
- Brain waves
- Blood oxygen levels
- Heart and breathing rates
Usually, you’ll have a polysomnography at a hospital or sleep center.
To be diagnosed with NES, you need to overeat at night for at least 3 months. The eating and sleeping patterns also can’t be due to substance abuse, a medical disorder, medication, or another psychiatric issue.
NES is tied to obesity, but it’s not clear if obesity is the cause or the effect of NES. One thing is known: The disorder makes it tough to lose weight. Not all studies have shown that you eat more if you have NES, and not everyone with night eating syndrome is obese.
Sleep troubles that come with NES also may contribute to weight gain. If you sleep poorly, you’re more likely to be overweight.
Antidepressants and cognitive behavioral therapy appear to help, though few studies have been done on NES. One small study found that relaxation training helped shift appetite from night to morning.
Several studies of antidepressants showed improvement with night eating, mood, and quality of life.
You may also take melatonin or substances that boost melatonin for NES.
As always, talk with your doctor before you take anything.
Scientists have explained what makes people wake up at night to eat
May 16, 2021
This could be a sign of an eating disorder.
If you caught yourself eating at night once, most likely it was an accident. But if visits to the refrigerator have become regular, it may be a symptom.
Why the habit of eating at night should make you wary
In general, our body knows very well that sleep and eating are fundamentally different processes. Therefore, when a person goes to bed, the level of leptin, a hormone that suppresses appetite, rises in his blood.
After waking up, he returns to normal. But the level of ghrelin increases – this hormone makes you think about whether it’s time to have a snack. This is how a healthy human body regulates appetite under normal conditions.
Failures can sometimes occur. Perhaps during the day you exercised too actively, and the body needs energy. Or they got nervous and the brain needs extra glucose to recover. Or maybe you just drank a lot of fluids before bed, and a full bladder keeps waking you up.
In general, due to some extraordinary situation, you do not have enough calories, you cannot fall asleep properly, the hormonal adjustment of appetite fails – and you find yourself at midnight in the refrigerator.
However, if you have attacks of night hunger at least a couple of times a week, the reason may be more serious.
Scientists say that nighttime eating is a fairly common thing. It most often occurs in people who are obese, as well as in those who take psychoactive substances or suffer from mental disorders.
In about 1.5% of the population, night eating becomes so pronounced that it is classified as a disorder – night eating syndrome.
Why people regularly wake up at night to eat, scientists do not know exactly. However, there are versions.
What draws you to the refrigerator at night
Here are some options.
1. You don’t get full during the day
Neuroscientist Nicole Avena, whose professional interests include nutrition, diets, food addiction, in a commentary to Vice, said that night meals occur when people begin to starve – for example, sit on too strict diet.
During the day, these people get so few calories that the circadian rhythm is completely disrupted. They do not have enough nutrients for a good sleep. Therefore, they wake up from the fact that the body insistently requires food.
This usually resolves as the body adjusts to food restrictions.
2. It’s a side effect of an eating disorder
Researchers have found that among those who eat at night, there are many people with diagnosed eating disorders. Thus, one study showed that 51% of patients with bulimia and about 35% with anorexia tend to eat food after midnight.
Professor of Psychology at the Perelman School of Medicine at the University of Pennsylvania.
When half asleep, people have less self-control. Therefore, a person who persistently avoids food during the day may well look into the refrigerator at night.
3. You are worried or live in constant stress
Protracted stress is a common cause of overeating. Including the night ones.
The same Professor Ellison found that about three-quarters of people who regularly eat at night have experienced some kind of stressful event. It was it that disrupted their sleep patterns and made late-night snacking appealing.
Other evidence suggests that people with depression or anxiety disorders are more likely to binge at night.
In fact, any type of mood disorder can cause a person to wake up and eat at night.
4. It’s just heredity
If someone close to you also wakes up at night to raid the refrigerator from time to time, you may have some kind of common gene that provokes this behavior. However, scientists have not yet calculated it.
Why is it bad to eat at night
If you go up to the refrigerator only occasionally, there is nothing wrong with that. But regular nighttime snacking can harm your health.
- Having eaten at night, you are likely to have a poor breakfast. So, you will experience a lack of energy in the morning.
- Nighttime digestion disturbs sleep. You will toss and turn in bed, waking up more often to go to the bathroom. As a result, you will not get enough sleep and throughout the day you will feel less efficient than usual.
- Frequent nighttime snacking increases levels of “bad” cholesterol and blood glucose over time. This means that the risk of cardiovascular problems, diabetes and obesity increases.
How to stop eating at night
Psychology professor Kelly Ellison offers one such option.
- Try replacing your meal with something else. For example, meditate, take deep breaths, read, or listen to soothing music.
- Find a way to make food difficult. Lock the kitchen or refrigerator at night, if it has such a function. Or make sure that you do not have foods that can be eaten immediately, without cooking: sausages, chips, pizza, chocolate. To cook something, you have to be fully awake, which means self-control will increase and you can abandon the idea of \u200b\u200ba night snack.
If simple methods don’t help, it makes sense to consult a general practitioner or psychotherapist who specializes in eating disorders. Perhaps in your case we are talking about some kind of malfunction in the body, and it is important to diagnose it as early as possible.
One thing you definitely shouldn’t do is take over-the-counter sleep supplements like melatonin at night. These drugs really help you fall asleep. But at night you will wake up sleepy and completely relaxed. This means that you will be even less in control of yourself.
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Night eaters: why they eat when they need to sleep
The individual picture of the syndrome, like the lines on the arm, is unique. Someone wakes up literally 10-20 minutes after going to bed and runs to the refrigerator. Someone gets up closer to the morning, and someone cannot remember their forays into food at all, and it is possible to restore the traces of the crime only by candy wrappers and wrappers. Someone calms down when he eats a lot, and for someone a small amount of food is enough, but this must be a forbidden delicacy. Someone breaks down, only left alone for the night, and someone arranges a whole quest to quietly get to the refrigerator.
What do these people have in common? Loss of self-control and subsequent feelings of guilt and shame. Many people call the morning states after nightly gluttony a “food hangover” – when there is no appetite, but only hatred, self-loathing and promises “I will fix everything” and “this will never happen again.”
Night eaters have common features:
- they suffer from anxiety, depression, low self-esteem;
- no appetite in the morning;
- eat up to 50% of the daily ration at dinner;
- suffer from insomnia;
- have an uncontrollable desire to eat during the night, and some eat in their sleep without waking up.
Reason 1: the birth of a child
“I had no problems with my first child, just a gift,” recalls 28-year-old Tatyana. – But with the second, the birth went with complications, and there were problems with feeding, and many anxious nights. I remember jumping up every hour to go to a crying baby, and on the way back I always looked in the refrigerator to eat something delicious. Such “rewards” in a year brought me about 15 kg. Now it is difficult to understand: whether it was these nightly reinforcements, or whether stress, fatigue and lack of sleep were the culprits. When the child became calmer and did not need to be approached at night, I still woke up several times and went to the refrigerator, as if my body was “on guard”, expecting that I was about to have to rush into battle.
The birth of a child is the most difficult test for a mother. There are many anxieties, experiences, and the body physically needs more strength, energy and more food. Often I can’t sleep all night without a break, I have to constantly refresh myself during the moments of wakefulness, and the “red button” immediately lights up in my head – oh horror, I eat at night. There is nothing left but to wait out this difficult period or make up for the deficit with at least daytime sleep, asking for help from loved ones.
Reason 2: painful separation
“After 12 years of marriage, my husband left for another woman,” says 42-year-old Tamara. – I can’t say that this was a complete surprise for me, “good people” have long hinted that he has someone on the side. And yet, when he left, I seemed to have fallen into the void. I didn’t want to go home, and when I came, I tried not to feel anything, stuck my head in the TV, took some food and flipped the channels endlessly. After some time, I realized that I began to gain weight, and decided to go on a diet. She returned home, drank a glass of wine at night and went to bed. But about an hour or two after that I woke up and went to the refrigerator.
I ate everything I could find
I ate everything I could find, I could even drink a few raw eggs. I constantly scolded myself, but I could not do anything about it. She left the refrigerator only when she felt bouts of nausea. I stopped buying anything at home, left the refrigerator empty, but the desire was so overwhelming that I ran to the 24-hour supermarket. Going to a therapist saved me, not because of the food, but because my pain of separation didn’t subside. In addition, my husband constantly called when he was drunk and told me how much he regretted leaving. The therapy took quite a long time, but when I felt better, the night attacks also went away. ”
Unfortunately, when we experience difficulties in life, we cannot always find emotional support in our environment. Then food, alcohol, everything that can dull unpleasant emotions becomes salvation. No matter how strong a person is, there are events that unsettle. And the last thing to do in this case is to scold yourself for trying to find relief. Tamara was lucky to meet a good specialist, but sometimes understanding relatives, friends or support groups, even in an online format, can become an emotional outlet. In such situations, the problem is not food or weight, but the inability of a person to cope with the situation and attempts to somehow forget.
Experts note that people suffering from nighttime eating syndrome often have a history of addictions (drugs, alcohol) and depression. Depression is especially aggravated in the evening, according to the principle of exhaustion of the psyche in a day. Often such people report sleep disorders (insomnia or the state of “no matter how much you sleep, you don’t get enough sleep”) – in fact, food here acts as a cure for these conditions.
Reason 3: new environment
“When I went to college, a lot of things changed in my life,” says 22-year-old Olga. – I moved to Moscow from a small town and began to live in a hostel. All around me, the girls talked about food all the time: what they eat, how much they weigh, and discussed newfangled diets. In one of these conversations, someone asked me if I wanted to get rid of my “provincial round cheeks”? At that moment, I experienced unbearable shame and decided to lose weight at all costs. I’ve never been overweight and never dieted, but suddenly I had a goal.
It was as if I couldn’t control myself and ate someone else’s
The first few kilos went away very quickly, and I was in seventh heaven with happiness, my face also stretched a little, and it became noticeable. But after a while, I began to wake up at night and, like a zombie, go to the refrigerator. He was alone in several rooms, and I had my own shelf. I didn’t buy food for the evening on purpose, but when I had such conditions, it was as if I couldn’t control myself and ate someone else’s. I was ashamed of this, in the morning I promised myself to go on an even more strict diet and kept on more or less all day, but at night the attacks were repeated.
Stress due to a change of residence and estrangement from loved ones forces one to look for ways to deal with it. But dieting is far from the best solution. The stronger the feeling of hunger, the more cunning tricks they come up with to get food. Kleptomania increases the feeling of guilt and self-dislike, life becomes even more unbearable and painful. One might even consider the idea that nighttime eating is itself “food stealing” that takes place on the fringes of consciousness.
How to overcome the “night eating syndrome”?
- Create your individual seizure profile. How often do they occur? How long ago did it start? What exactly are you eating? How much do you eat? Does the presence of other people in the apartment affect your nighttime behavior? Do you have seizures if you are not at home overnight? What is the structure of your sleep? How long before bed do you eat? Do events during the day affect the manifestation of seizures?
- Do not self-flagellate. Overnight binge eating is a problem, and you need support from yourself, at least. Why shouldn’t you berate yourself? Because every promise “it won’t happen again” is a fall into the abyss of despair and impotence, when you can’t keep your word. These emotions most often lead to overeating, not just at night.
- Develop a plan of action. This may be the end of strict diets. Of course, it’s easier said than done. But fighting a starving subcortex is like fighting a giant wave: you can’t beat it, you can only learn to maneuver on its crest. This may include reviewing your habits in relation to the sleep/wake cycle, undergoing a medical examination. And, of course, an appeal to a psychologist or psychotherapist.
About the expert
Julia Lapina — clinical psychologist. She studied psychotherapy and psychoanalysis in Switzerland (Zurich), worked with Russian-speaking patients living in Switzerland, both in the clinic and in private. Works with patients with eating disorders (anorexia, bulimia, compulsive overeating), leads master classes and lectures on the practice of intuitive eating.
Text: Tala Klimova Photo Source: Getty Images
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