Night Eating Syndrome (NES)

What is night eating syndrome?

Night eating syndrome (NES) is when you wake up several times in the middle of the night to eat. You may eat a large amount of your daily food intake after dinner and before breakfast.

Occasional night eating is common. Depending on how your day went, you may eat your evening meal later, have a late-night snack or wake up hungry if you missed a meal. But night eating syndrome doesn’t just happen every once in a while. It happens several times per week, often with multiple wakeups per night. Night eating syndrome is an eating disorder that happens alongside a sleep disorder (insomnia).

If you have night eating syndrome, you don’t sleep through the night. Your body wakes you up so you can eat. You crave sweets and foods high in carbohydrates. You may feel like you won’t be able to fall back to sleep if you’re not full. In the morning, you don’t feel rested or hungry for breakfast. This can affect your mood and your ability to perform well at work or school.

Untreated, night eating syndrome makes it difficult to maintain a healthy weight. It also increases your risk of health problems related to obesity. Treatment is available for NES.

How common is night eating syndrome?

Night eating syndrome affects an estimated 1.5% of people in the United States. This is about 5 million people.

What are the symptoms of night eating syndrome?

The symptoms of night eating syndrome include:

• Waking up in the middle of the night to eat (multiple times per night and more than four times per week).
• Eating more than 25% of your daily food intake after dinner and before breakfast.
• Craving foods that are high in calories, carbohydrates or sugar at night.
• Being consciously aware of night eating and able to recall it during the daytime.
• Skipping breakfast or not eating your first meal until the afternoon.
• Not being able to function as expected during daytime hours.

You may feel:

• Ashamed.
• Anxious.
• Depressed.
• Embarrassed.
• Exhausted.

What causes night eating syndrome?

Healthcare providers don’t know exactly what causes night eating syndrome. Studies suggest it happens due to changes to your circadian rhythm. This is your body’s natural “clock” that regulates when you feel tired, alert and hungry. If you have NES, your internal clock doesn’t work like it should. Your body releases hormones that make you feel hungry and alert at night rather than during the day.

The following factors may contribute to night eating syndrome:

• Genetics: NES may run in your biological family history, which means it could have a genetic link.
• Stress: You might notice that your symptoms get worse when you feel stressed.
• Daytime eating habits: If you don’t get enough calories during the day, you’re more likely to feel hungry and eat at night.

What are the risk factors for night eating syndrome?

Night eating syndrome is more common among people who have:

• Overweight.
• Depression or anxiety.
• Substance use disorder (SUD).
• Another eating disorder, such as bulimia nervosa or binge eating disorder.

What are the complications of night eating syndrome?

Eating a lot of calories at night can lead to obesity. Complications of obesity may include:

• Diabetes.
• High blood pressure.
• Heart disease.

How is night eating syndrome diagnosed?

A healthcare provider will diagnose night eating syndrome after a physical exam and testing. During the exam, your provider will ask about your symptoms, including how often you wake up at night and what helps you get back to sleep. They’ll check your physical health and ask questions about your mood, emotions and mental health.

Your provider may ask you to keep a sleep diary. This is a record of when you go to bed, wake up and what you eat at night. It can help your provider learn more about what your nighttime behavior looks like.

You may need to participate in an overnight sleep study so your provider can monitor your activity as you sleep.

How is night eating syndrome treated?

To treat night eating syndrome, your provider may recommend one or a combination of the following:

• Cognitive behavioral therapy (CBT): A type of talk therapy that can help you address certain behaviors and adopt healthier habits.
• Antidepressant medications: Medications such as selective serotonin reuptake inhibitors (SSRIs) may boost your mood and regulate your emotions.
• Progressive muscle relaxation: PMR is a way for you to relax your muscles, destress and ready your body for sleep. It can also help you calm down if you feel anxious.
• Light therapy (phototherapy): Light therapy adjusts your circadian rhythm so you’ll feel sleepy at night and awake during the daytime. It also helps your mood.
• Melatonin: This is a hormone that regulates your sleep-wake cycle. Your provider may recommend taking melatonin supplements to help you get to sleep and stay asleep at night.
• Weight management program: A healthcare provider can help you maintain a healthy weight and choose nutritious foods to eat during the day.

Hypnosis for night eating syndrome

Hypnotherapy (hypnosis) is a type of mind and body treatment to deeply relax you and focus your concentration. Hypnotherapy can help you manage conditions like obesity, which is associated with night eating syndrome.

You may be interested in this type of therapy to be more open to making healthy changes in your life. You can also use it in combination with other types of treatment for NES.

Can night eating syndrome be prevented?

You may not be able to prevent all causes of night eating syndrome. But you can take steps to improve your health and get restful sleep by:

• Choosing healthy foods: Make sure you only have nutritious foods at home. Getting rid of foods that are high in fat and sugar can help you avoid indulging in them at night.
• Practicing good sleep hygiene: Keep your bedroom at a comfortable temperature, and try to go to sleep at the same time every night. Avoid caffeine and using electronics before bed.
• Keeping an eye on your mental health: Try to manage stress with meditation and deep breathing. If you feel sad or anxious, talk to your provider. Counseling and therapy can help you manage emotions and improve your mood.
• Staying active during the day: Regular physical activities during the day help you sleep better at night and regulate your mood.

What’s the outlook for night eating syndrome?

Treatment for night eating syndrome is often successful in helping you manage your symptoms. You may need to try more than one or combine treatments to find what works best for you. Your healthcare provider can help you along the way.

Treatment takes time and patience — it doesn’t happen overnight. You’ll have a better outcome if you stick to your treatment plan and work closely with your providers, even when you feel better.

Untreated night eating syndrome can cause health problems and emotional challenges. It’s difficult to make changes to your routine. You might feel overwhelmed or that your outlook is hopeless. This can sometimes lead to thoughts of suicide. Help is available if you’re in a rough spot. Talk to your provider or call or text 988 (U.S.). This is the Suicide & Crisis Lifeline. Someone is available to talk with you 24 hours a day, 7 days a week.

When should I see a healthcare provider?

Call your provider if you have symptoms of night eating syndrome. It’s important to see your provider for an evaluation so they can check for health conditions that might be causing you to wake up at night. Talk to your provider if you also experience mental health challenges like depression or anxiety.

What questions should I ask my healthcare provider?

You may want to ask your provider:

• What’s causing night eating syndrome symptoms?
• What type of treatment do you recommend?
• Should I talk to a mental health professional?
• Are there side effects of the treatment?
• What changes to my routine can I make to improve my sleep?