Night eating syndrome (NES)

Dear Mary,

Sneaking late night snacks might just seem like an unhealthy habit, but the truth is that night eating syndrome (NES) — and a related syndrome called sleep related eating disorder (SRED) — are actually diagnosable conditions for some people. NES is technically classified as disordered eating, but researchers believe it’s also related to sleep disorders, making it a sort of hybrid condition. In both NES and SRED, people consume significant amounts of food after dinner; usually about 35 percent or more of their daily calories are eaten late in the evening or in the night. The main difference is that folks with NES are fully conscious of their night eating, whereas those with SRED are usually completely or partially asleep when they are eating at night. Figuring out which of these sounds most like what you're experiencing might be the first step to seeking treatment. Since you’re specifically curious about NES, read on to hear about causes and treatments (but, if you’d like to know more about SRED, check out Mayo Clinic’s site).

Currently, scientists’ understanding is that NES may be your body’s attempt to compensate for improper levels of a hormone called serotonin. It turns out that many of the calorically-dense and carb-rich foods that night eaters choose are quite efficient at increasing serotonin in your brain. Because serotonin helps to regulate your sleeping and feeding cycle (your “circadian rhythm”), night eating might be your body’s way of self-medicating or signaling that your serotonin levels and circadian rhythm are out of whack. On top of that, studies show that levels of other hormones in your body — such as leptin, which suppresses hunger — also shift away from a normal cycle. Usually, your circadian rhythm would ensure that your sleeping hours aren’t interrupted by hunger; with NES, that isn’t the case.

While researchers admit that there’s still a lot to learn about NES, they do know that increasing your serotonin can help. Selective serotonin reuptake inhibitors (SSRIs) — typically prescribed as antidepressants — have been used successfully in those with NES to reduce post-dinner binging. If your night eating tends to be in the middle of the night rather than late evening, a different antidepressant, known as agomelatine, might be a better bet (it regulates melatonin levels, which are also related to your sleep-wake cycle). Because NES is a hybrid condition involving eating behaviors, sleep behaviors, and your mood, you could look into chatting with a registered dietitian, spending a night in a sleep lab, or seeking out psychotherapy. Seeing one or a combination of these providers may be the right formula for you.

As you digest this information, you might also consider the areas of your life that your night eating might be impacting. Physically, the consequences of untreated NES can include weight gain and a loss of appetite for daytime meals. But, there can be social and psychological factors to consider, too. How does your nighttime eating make you feel emotionally? Do your loved ones know you’re struggling with this, or do you hide your behavior? Do you see any ways they could support you? Are there changes to your environment — such as keeping high-calorie snacks out of the house — that you could test out? It’s possible, too, that feelings of anxiety or stress could be the reason for your off-kilter eating cycle. Whatever treatment option you ultimately pursue, know that there seems to be hope for finding a way to keep those square meals during the daytime, so you can get those uninterrupted zzzs at night.