Circadian eating and sleeping patterns in the night eating syndrome

OBJECTIVE: To compare the eating and sleep-wake patterns of persons with the night eating syndrome (NES) with those of matched control subjects. RESEARCH METHODS AND PROCEDURES: Forty-six overweight/obese NES subjects (mean age 43.3 +/- 9.8 years; 32 women) and 43 similar controls (mean age 39.0 +/- 11.0 years; 28 women) wore wrist actigraphs for 7 days and completed sleep and food diaries at home. RESULTS: There was no difference between the total energy intake of the NES and the control subjects, but the pattern of energy intake differed greatly. Relative to control subjects, the temporal pattern of food intake of night eaters was delayed. Food intake after the evening meal, as a proportion of the 24-hour intake, was more than 3-fold greater in NES subjects than in controls (34.6 +/- 10.1% vs. 10.0 +/- 6.9%, p = 0.001). NES subjects had sleep onset, offset, and total sleep duration times comparable with those of controls. NES subjects reported more nocturnal awakenings than did controls (1.5 +/- 1.0 per night vs. 0.5 +/- 0.5; p < 0.001), and their actigraphically monitored arousals occurred earlier during sleep (at 128 minutes after sleep onset vs. 193 minutes, p = 0.01). NES subjects consumed food on 74% of the awakenings vs. 0% for the controls. DISCUSSION: The pattern of cumulative energy intake of the night eaters suggests a phase delay in energy consumption relative to sleep-wake times. NES may involve a dissociation of the circadian control of eating relative to sleep.