Night Eating Syndrome
Night Eating Syndrome is classified under the diagnostic heading Other Specified Feeding or Eating Disorder (OSFED) in the new DSM-5. Recurrent episodes of night awakenings from sleep characterized by excessive eating or defined by excessive consumption of food after eating one’s evening meal. There is usually awareness of the eating events and the episodes cause significant distress and impairment in functioning.
Patients with night eating also will report a lack of control with this eating, often leading to binge eating behaviors. While some patients may report a long history of night eating behaviors, many present for treatment because of the onset of these out-of-the-ordinary patterns that developed in the recent weeks or months. For a diagnosis of night eating syndrome, the patterns should not be related to changes in one’s sleep-wake cycle or by social norms. The condition should also not be better explained by the use of substances such as alcohol, marijuana, or other illicit substance use which can often lead to these types of behaviors.
It is also important to note that some medications, especially sleep medications, can often cause patterns of night eating. Patients on some of these medications have been known to engage in behaviors such as sleep-walking and making full meals, while in an altered state of wakefulness. Many times these events occur completely without recall and can cause great distress in an individual. Others may have some recall without much insight into their behaviors.
Treatment involves identifying any triggering events and ruling out any medical contributions. Psychotherapy remains a mainstay and the use of medications such as selective serotonin uptake inhibitors (SSRIs) have shown some effectiveness. At times, spontaneous remission is possible however early intervention can be helpful to reduce the risks that night eating syndrome does not develop into binge eating disorder or bulimia nervosa. Intervention also is important to improve daily energy expenditures and functioning.