Night eating syndrome – causes, diagnosis and treatment. What are the symptoms of SNS?

Episodes of nighttime eating are normal when we work the night shift, for example, but they always lead to disorders, for example, in the digestive system. The correct circadian rhythm of nutrition includes eating during the day, i.e. during the period of greatest activity, when our body needs the most energy. At night, when we sleep, we do not need to supply the body with energy from food, although the body still burns calories.

Night eating syndrome is more common in obese people. Several studies have confirmed the link between SEP and bulimia and morbid obesity. Due to the symptoms of night eating syndrome, it is classified as a sleep-related eating disorder. It is worth learning more about the causes, symptoms, and treatment of nighttime eating disorder in order to avoid the complications associated with this eating disorder.

Eating Disorders: What is Night Eating Syndrome (NES)?

Night eating syndrome was first described in 1955. Night eating syndrome affects 1.5% of the adult population. First diagnosed in obese people. This eating disorder causes some diagnostic difficulties because it requires differentiation, i.e. snacking due to chronic stress.

SES is an eating disorder that is manifested by changes in the circadian rhythm of food intake. In particular, this applies to people with morbid obesity – it is estimated that 8-42% of people with morbid obesity suffer from this eating disorder, which further complicates treatment, leading to an increased risk of premature death.

Night eating syndrome causes, among other things, sleep disturbances and increased appetite in the evening. Eating at night is compulsive. Interestingly, many patients in the morning do not remember visiting the kitchen at night.

Night eating syndrome is diagnosed based on several criteria. It is not always possible to say with 100% certainty that nighttime snacking is associated with NES – it may indicate other, non-specific eating disorders or medical conditions.

Night Binge Syndrome – Diagnostic Criteria for this Eating Disorder

Night Eating Syndrome – NES Criteria:

1. Increased food intake at night:

• ≥ 25% of all energy comes from dinner,

• at least 2 episodes of nocturnal awakenings per week are associated with food intake.

2. The clinical picture is characterized by at least 3 of the following features:

• skipping breakfast at least 4 times a week,

• increased appetite after dinner, before bed and at night,

• insomnia and / or other sleep disorders at least 4 times a week,

• eat to help them sleep – patients are convinced that eating at night will help them fall asleep,

• low mood or diagnosed depression – symptoms worsen in the evening and at night.

3. Fear of episodes of heavy meals at night.

4. Disorders are associated with increased irritability and difficulty in functioning in everyday life.

5. The listed violations last for at least 3 months.

6. The listed disorders are not the result of diseases, drugs, addictions or other mental disorders.

Nighttime binge eating, while it may indicate nighttime binge eating syndrome, is not always associated with it. A characteristic feature of this disorder is its association with overweight and the occurrence of insomnia (difficulty sleeping).

SNP (night eating syndrome) – causes of the disorder

It is not known what causes some people to feel increased appetite during the day and evening and overeat at night. Various studies have produced conflicting results. Some of them proved the connection of the NES with the male sex, while others were related to the female gender.

Factors that increase the risk of developing night eating syndrome have been identified, including:

• obesity,

• insomnia or sleep disturbances,

• restless leg syndrome

• sleep apnea,

• group of periodic limb movements,

• certain medications, including those for insomnia,

• long-term use of diets,

• disturbances in the functioning of the body after stopping the use of psychoactive substances – nicotine, alcohol, coffee and opiates.

According to psychodynamic ideas, the phase of oral development, which is based on the relationship between mother and child, is disturbed in the night eating syndrome. Patients eat at night, thus replacing dreams that cause them strong internal resistance. The cognitive model suggests that binge eating avoids feelings of emptiness or failure.

Studies have shown that night eating syndrome can occur in a conscious form – the patient is aware that he eats at night, and in a form manifested by eating during sleepwalking.

Among patients who seek specialist help for nighttime eating, only 1-2% meet diagnostic criteria. Although night eating syndrome is more likely to affect people who are obese, it can also occur in lean people, in whom SES usually begins in early adolescence. Not all people who meet the diagnostic criteria for SNS are obese – this primarily applies to people from Mediterranean countries.

More often, night eating syndrome is diagnosed in people with type 2 diabetes, anxiety disorders, sleep disorders, and other eating disorders.

What are the symptoms of Night Eating Syndrome (NSE)?

Symptoms of night eating syndrome include:

• morning behavior typical of anorexia (morning lack of appetite) – skipping breakfast and taking morning food a few hours after waking up, at least 4 times a week;

• the use of predominantly high-calorie foods at night;

• excessive appetite in the evening;

• poor sleep quality – trouble falling asleep, frequent awakenings from sleep, insomnia at least 3 times a week.

Symptoms of NEP also include:

• evening increase in leptin and cortisol levels and a decrease in melatonin levels,

• night eating under the influence of negative emotions,

• mood disturbances during the day, performance impairment and depression in the evening and at night

• get up often at night to eat,

• internal compulsion to eat at night,

• feeling out of control, feeling ashamed and guilty about eating at night.

Treating Night Eating Syndrome

They are mainly used to treat SNS. antidepressants And antiepileptic drugs. Patients should be referred to a sleep disorder clinic. Pharmacological treatment is complemented by, among others:

• behavioral techniques

• relaxation techniques,

• diet education.

Therapy also includes quantitative and qualitative changes in the diet, as well as the treatment of disorders of the secretion of antipsychotics and hormones.

Treatment of night eating syndrome, like many other eating disorders, is difficult. Unfortunately, its effects are not always satisfactory, because the effectiveness of treatment is influenced not only by the choice of therapy, but also by the cooperation of the patient with specialists who provide support to a person who has difficulty with nighttime eating.

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