Night Eating Syndrome in Patients With Obesity and Binge Eating Disorder: A Systematic Review

Night eating syndrome (NES) is currently classified as an Other Specified Feeding or Eating Disorder (OSFED) under the Diagnostic Statistical Manual−5 (DSM-5). This systematic review aims to consolidate the studies that describe the sociodemographic, clinical and psychological features of NES in a population of patients with eating disorders (ED), obesity, or those undergoing bariatric surgery, and were published after the publication of the DSM-5. A further aim was to compare, where possible, NES with BED on the aforementioned variables. Lastly, we aimed to appraise the quality of the studies being included in the review. We conducted a systematic search on three databases (MEDLINE, PubMed and Embase) which resulted in the selection of 22 studies for the review. We included the articles that studied patients with NES and their sociodemographic, clinical and psychological features in a clinical (i.e., ED, obese or bariatric surgery) population, through a quantitative study design. Articles were excluded if the NES patients included in the study had a comorbid psychological disorder, and/or the sample was collected from a university/non-clinical population, and/or the study design was qualitative, and/or NES features were compared with any other disorder, except BED. Our study found that no conclusions about the link between any sociodemographic feature (such as, age, gender, income, etc.) and an NES diagnosis could be made. Further, NES patients presented with elevated ED pathology (including emotional eating and loss of control eating) and higher occurrence of depressive symptoms than controls. Contrary to the literature suggesting that NES and Binge Eating Disorder (BED; an ED subtype which is also comorbid with obesity) patients often report overlapping features, questioning the validity of NES as an ED diagnosis, we found that BED can be differentiated from NES by the higher occurrence of emotional eating, body related concerns and abnormal eating episodes. The review also suggested an overlap between NES and Sleep-Related Eating Disorder. We recommend that it is essential to study NES as an independent disorder to further develop its diagnostic criteria and treatment options, thereby, increasing the quality of life of the patients suffering from this syndrome.

Effects of Anxiety, Depression, and Stress on Sleep Disorder and Night Eating Syndrome in Adolescents: Results of an Internet Survey

PurposeThe current study examined how sleep quality is related to night eating syndrome (NES) via the indirect effects of anxiety, depression, and stress to determine the mechanism of its development. MethodsThis cross-sectional web-based study included 171 adolescents aged 12-18 years (55.0% girls). Participants completed the self-report Night Eating Questionnaire (NEQ), Scales for Outcomes in Parkinson’s disease (SCOPA) Sleep Scale, and Depression, Anxiety and Stress Scale–21 items (DASS-21). ResultsThe results showed that anxiety, depression, and stress directly influenced the NEQ. AMOS path analysis was used to examine whether these also had an indirect influence on the NEQ. Moreover, for the anxiety, depression, and stress subscales, only the anxiety subscale influenced nighttime eating problems due to increased sleep problems, which in turn increased the difficulty of morning sleepiness and falling asleep at night. ConclusionConsequently, depression and stress directly increased nighttime eating problems. Anxiety exacerbates eating problems, both directly and indirectly, through sleep. Behavioral and psychological interventions to reduce anxiety, depression, and stress may be helpful strategies for the treatment of night eating syndrome.Level of evidence: Level IV

A Cross-Sectional Study of Evening Hyperphagia and Nocturnal Ingestion: Core Constituents of Night Eating Syndrome with Different Background Factors

This web-based cross-sectional survey aimed to elucidate the differences between the two core symptoms of night eating syndrome (NES): evening hyperphagia and nocturnal ingestion in the general Japanese population aged 16–79 years. Participants who consumed at least 25% of daily calories after dinner were defined as having evening hyperphagia. Those who consumed food after sleep initiation at least twice a week were determined to have nocturnal ingestion. Of the 8348 participants, 119 (1.5%) were categorized in the evening hyperphagia group, 208 (2.6%) in the nocturnal ingestion group, and 8024 in the non-NES group. Participants with evening hyperphagia and nocturnal ingestion had significantly higher anxiety scores (p < 0.05 and p < 0.001, respectively) and depression (p < 0.001 for both) than those without NES. Multiple logistic regression analysis revealed that evening hyperphagia was significantly and independently associated with higher body mass index, shorter sleep duration, later sleep-wake schedule, and higher insomnia score, while nocturnal ingestion was significantly and independently associated with younger age, smoking habit, living alone, earlier sleep-wake schedule, and higher insomnia score. Sleep duration and sleep-wake schedule characteristics in the two groups were opposite, suggesting differences in the sleep pathophysiology mechanisms.

Опитувальник для визначення синдрому нічного переїдання (NEQ) – валідація та адаптація для української популяції

Синдром нічного переїдання (СНП, night-eating syndrome) належить до «Інших специфічних порушень харчової поведінки». СНП характеризується наявністю нічного вживання їжі, безсонням, ранковою анорексією та розладами настрою і сну. Цей вид порушення харчової поведінки (ПХП) притаманний пацієнтам з ожирінням або надлишковою масою тіла та цукровим діабетом 2-го типу (ЦД2). Наявність СНП погіршує метаболічний контроль ЦД2 та ускладнює лікування цього захворювання. Наразі існує лише один метод, який дозволяє діагностувати цей синдром — опитувальник для визначення СНП (Night Eating Questionnaire, NEQ). На жаль, він не адаптований для використання в україномовній популяції. Мета: адаптувати та оцінити валідність української версії NEQ для застосування серед пацієнтів із ЦД2 та ожирінням або надлишковою масою тіла. Матеріал і методи. 105 осіб (37 чоловіків та 68 жінок, вік — 60,3±7,2 року, індекс маси тіла (ІМТ) — 31,9±3,7 кг/м2) із встановленим діагнозом ЦД2 та ожирінням або надлишковою масою тіла заповнили перекладену версію NEQ. Внутрішню узгодженість опитувальника оцінювали за допомогою показника α-Кронбаха. Конвергентну валідність встановлювали за допомогою кореляції з «Опитувальником щодо розладів харчової поведінки» (Eating Disorder Examination Questionnaire, EDE-Q). Через 3 тижні 34 учасники пройшли ретестування. Результати. У 17 учасників (16,2%) було встановлено діагноз СНП. Середній загальний бал опитувальника становив 17,3±5,1. Загальна надійність шкали (α-Кронбаха) для всього тесту становила 0,76, міжкласовакореляція — 0,81. Була встановлена 4-факторна структура опитувальника, яка відповідала оригінальній версії. Загальний бал NEQ корелював із результатом EDE-Q (r=0,56). Надійність ретесту була висока (0,71). Показник ІМТ та HbA1c cтатистично не відрізнявся в пацієнтів із та без СНП. Середній загальний бал опитувальника не корелював з ІМТ (p>0,05). Висновки. Поширеність СНП серед пацієнтів із ЦД2 становить 16,2%. Україномовна версія опитувальника є надійною та валідною для оцінки наявності СНП. Опитувальник може використовуватися в цієї категорії пацієнтів для встановлення діагнозу та вибору відповідного лікування. Необхідні подальші дослідження ефективності NEQ серед пацієнтів із ЦД2 та нормальною масою тіла, а також в осіб з ожирінням або надлишковою масою тіла, але без цукрового діабету.

Sleep Quality and Eating Disorder-Related Psychopathologies in Patients with Night Eating Syndrome and Binge Eating Disorders

Night eating syndrome (NES) is an eating disorder (ED) characterized by nocturnal ingestion (NI), evening hyperphagia, morning anorexia, as well as mood and sleep disturbances. This study compared subjective and objective sleep quality and ED-related psychopathologies in patients seeking treatment for ED. Method: The sample was composed of 170 women, aged 18–68, who were referred for an ED assessment from 2011 to 2020. The participants were divided into three subgroups: NES-NI only (n = 30), NES+ binge eating (BE) (including binge eating disorders or bulimia nervosa (n = 52), and BE-only (n = 88). The measures consisted of a psychiatric evaluation, objective sleep monitoring measured by an actigraph for 1 week, a subjective sleep self-report, and ED-related psychopathology questionnaires. Results: Objective sleep monitoring revealed significant group differences, with higher sleep efficiency in participants with BE-only and longer sleep durations for the NES-NI only group. Subjectively, the BE-only group described a significantly lower sleep quality than either the NES-NI only or the NES+BE groups. ED-related psychopathology was lower in the NES-NI-only group. A stepwise linear regression revealed that general psychopathology (the brief symptom inventory total score) was a significant predictor of subjective sleep quality. Conclusion: NES-NI-only was correlated with less psychopathology, but with more subjective and objective sleep disturbances. These results lend weight to the supposition that NES lies on a continuum of ED psychopathologies, and that NES-NI-only appears to be a separate entity from NES+BE and BE-only in terms of its psychopathology.

Night Eating Syndrome and Its Association with Sleep Quality and Body Mass Index Among University Students During the Covid-19

Night eating syndrome (NES) is a disordered eating behaviour characterized by hyperphagia at night and is often accompanied by a sleep disturbance. This study aims to determine the prevalence of NES and its association between sleep quality and body mass index (BMI) among the private university students during the Covid-19. A total of 166 students from a private university participated in this cross-sectional study. Online self-administered questionnaires were used to collect and determine socio-demographic data, BMI, NES, and sleep quality. NES was assessed using Night Eating Diagnostic Questionnaire (NEDQ) while sleep quality was assessed using Pittsburgh Sleep Quality Index Questionnaire (PSQI). The results showed that 38.6% of the participants were engaging with NES, 45.2% were having poor sleep quality and 25.9% were overweight or obese during the Covid-19. There were significant associations between NES with sleep quality and BMI, which students with NES were found to have poorer sleep quality (r=0.306, p<0.001) and higher BMI (r=0.024, p=0.763). In addition, poor sleep quality was found to be positively associated with BMI (r=0.161, p=0.038). Males (AOR=2.198, 95% CI=1.005-4.808) and poor sleepers (AOR=1.176, 95% CI=1.028-1.346) were the risk factors of NES. In conclusion, the prevalence of NES, poor sleep quality, and overweight and obesity were at an alarming rate. NES was found to be related to both poorer sleep quality and higher BMI among the students. Therefore, interventions such as behavioural and cognitive therapy should be implemented to promote healthy eating behaviour among university students.