Do you feel a compulsive need to eat at night?

Do you keep waking up to snack at night? What is often simply put down as a bad habit may actually be NES. — dpa

I like to eat late at night ­(supper) because I can’t sleep if I’m hungry. My husband always tells me not to do it because that would lead to reflux and weight gain, and all sorts of unpleasant things like insulin resistance. Then I heard about this condition called Night Eating Syndrome. Do I have it?

Eating supper and then going straight to bed is indeed unhealthy for all the reasons your husband mentioned.

It is better to eat more protein during dinner (30g to 50g), ­preferably two to three hours before bed, to satisfy your ­hunger cravings and keep you feeling full for longer than to eat supper.

However, Night Eating Syndrome (NES) is a whole ­different kettle of fish.

It is a disorder that happens when you actually wake up at night to eat.

This means that you are already sleeping, then you wake up feeling hungry and absolutely have to eat because you cannot fall asleep again unless your stomach is full.

This disorder interferes with your sleep, as well as your ­daytime mental and physical functioning.

I don’t do that – I eat supper and then I go to sleep. But I ­certainly don’t wake up periodically at night to eat.

Then you don’t have NES.

People who have NES can sometimes wake up several times at night just to eat.

This happens several times a week, and several times a night.

The thing is, people who have NES may have had a full dinner, but they still wake up several times a night to eat.

Therefore, it is an eating disorder that is usually paired with insomnia.

And despite eating so much at night, these people often wake up hungry as well.

Those with NES eat a significant amount of their daily food after dinner and before breakfast.

Here is how you can tell if you may have NES:

• You wake up in the middle of the night to eat multiple times, and more than four times a week.
• You eat more than a quarter of your daily food intake after dinner and before breakfast.
• You know you woke up at night to eat, and you can remember that you did such a thing when you are awake in the daytime (i.e. you’re not eating while sleepwalking).
• You skip breakfast and usually don’t eat your first meal until afternoon.
• You cannot function during daytime hours.

   

  You may feel sleepy and have difficulty focusing.

  You may have the typical complications of insomnia.

• You may feel anxious, depressed, ashamed, irritable and exhausted.

   

  This worsens during the night.

I have never heard of this ­syndrome before. Is it ­common? What causes it?

No one knows exactly what causes it, but it affects as many as 1.5% of people in the United States.

While we don’t have the data for Malaysia, it is possible that many people don’t recognise it as a syndrome as they might not be aware of it, nor do they seek a doctor’s help for it.

They may think it’s normal behaviour or just a bad habit they adopted because Malaysia has eateries that open all night and our food is so delicious!

NES affects both women and men equally.

Some studies say NES may be due to these people having a ­different circadian rhythm than those who don’t have NES.

The circadian rhythm is your body’s natural clock, which ­regulates what time you wake up, when you feel hungry enough to eat and when you go to sleep.

In people with NES, the circadian rhythm does not work like it should.

Typically, we should eat during the day, then feel tired and go to bed at night at the appropriate time.

However, the bodies of those with NES release hormones like cortisol and insulin, which make them feel hungry and alert, at night instead of during the day.

Lab tests have indicated that people with NES have lower ­serotonin, melatonin (a hormone that helps you sleep), ghrelin and leptin (a hormone that tells you that you are full) hormones.

It is possible that NES may be genetic and run in families.

It may also be due to stress and not getting enough food during the day, leading to you feeling hungry and eating more at night.

People who are more at risk of getting NES are:

• University students, as they often keep late hours
• Pregnant women, as their ­hormones may sometimes ­fluctuate unpredictably
• Shift workers, as they may keep late hours, or even work throughout the night.

If I have NES, is there any type of food that I may crave more of?

Yes, people with NES tend to crave more carbohydrates, ­especially sweets and other items with high calories.

Is this bad for me ultimately?

Yes, definitely.

You may go on to become obese and develop insulin ­resistance, leading to high blood pressure and diabetes.

This can ultimately lead to higher risk of heart disease, ­kidney disease and strokes.

People who have NES usually have poor and fragmented sleep.

You don’t get the full sleep cycle that you need to feel refreshed in the morning and energised enough to get through the day.

Is there any treatment for NES?

Yes, it is quite treatable.

But you first have to recognise it and seek help from a psychiatrist.

The psychiatrist may recommend cognitive behaviour therapy (CBT), antidepressants, muscle relaxation techniques, light therapy, melatonin and/or weight management.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, ­computers and entertainment. For further information, email ­[e-mail]. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.