Night Eating Syndrome

Disordered eating sometimes appears as night eating syndrome, a phenomenon in which a person wakes up during the night with a desire to eat. In general, the person has trouble getting back to sleep until he fulfills this desire.

Estimates suggest that 1-2% of the population has night eating syndrome, but the rate is as high as 6% among those who are obese.

A person with night eating syndrome experiences a daily cycle with respect to food intake. After a large amount of food consumed during the night, the person eats very little, if anything, for breakfast. Light food intake continues through the day, while the individual's mood tends to become more depressed. Dinner includes consumption of a significant amount of food, but the majority of food intake occurs after dinner and at one or more times during the night. This eating does not normally qualify as binging; it is usually drawn out over several hours.

The food consumed at late hours is often high-calorie, starchy food. Carbohydrates adjust the chemical balance in the brain, increasing serotonin levels. Increased serotonin, in turn, helps the person to sleep.

However, the extra food intake during the night inspire guilt and shame, which can again lead to avoidance of breakfast, helping to keep the cycle going.

While the cycle is clear, the reasons for it are not. It may be that those with night eating syndrome simply have hormonal imbalances. A popular theory is that these hormone problems come from excessive stress. Stress leads to production of cortisol, a hormone that tells the body that stress is present. Night eating syndrome may be the body's way of trying to address the excess levels of cortisol.

• For hormonal issues, one way to combat night eating syndrome is to administer tryptophan. Tryptophan has a similar effect to carbohydrate consumption; it ultimately results in a raised level of serotonin.
• A drug that shows promise in treating night eating syndrome is sertraline (Zoloft).
• Of course, it is also helpful to address the issues that create stress. This often calls for some form of mental health counseling.
• Finally, an evaluation at a sleep clinic may reveal sleep disturbances that can contribute to night eating syndrome.