Have you or anyone you know ever recorded how many hours of real sleep you get? Have you ever woken up hungry because you ate at the same time the night before? Night Time Binge Eating Disorder or NES was first recognized in 1955. It is not currently considered an eating disorder, but we can learn some things about eating at night from research (Costain, 2000-2013) and know that many daytime activities and non-activities play a role in efficaciously meeting our personal sleep needs. Beyond disease, this article aims to review the idea of sleep itself and spark the reader’s critical thinking about what aspects of their evening cravings can be sleep-related to sleep habits and what to look for when asking for resources.
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Typically, neurotransmitters secreted by neurons in our brain stem keep us awake during the day, while different nerve hormones switch on and circulate to aid the refreshment and sleep of our brains (National Institutes of Health (NIH), 2008). As individuals, we also place ourselves into patterns that are easily repeated whether out of stress, necessity, or ailment. According to the NIH, our human bodies follow a 25-hour circadian rhythm that can be altered by a daily alarm, such as a clock at 6am or 7:30am, laptop use at 11pm that prevents us from falling asleep, or shopping in a warehouse-lit building right after our work shift or because our kids are asleep or both. Solutions to these choices include working under bright lights at work, using a full-spectrum natural light in the early morning or blue light to shift sleep-wake patterns, and simply practicing sleep hygiene, that is, going to bed at a regular hour of the day.
If you happen to question the amount of food and/or caloric fluids consumed in a short amount of time, or know that consuming an additional 500 calories when not hungry at all in the evening, it likely will begin to affect your overall well-being . (Costain, 2000-2013). Eating in the middle of the night and unaware of this behavior may be Night Time Binge Eating Disorder, (NBED) or Night Eating Syndrome (NES). So what can be done?
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When looking at cravings and why they happen around bedtime, Costain (2000-2013) and the writer of this article recommend keeping a food diary and sleep record for three days or even 24 hours to see if in fact you really do consume little during the day and your hunger finally catches up with you at odd hours during off-work time.
Additional solutions to reducing cravings at night include balancing your diet, adding exercise or stretching and movement for as little as 10 minutes a day, being active after you eat at night, and checking for depression or anxiety that may be waking you in the hours of self-care time. Here is a wonderful depiction of anxiety prior to sleep in patients with anxiety and patients with a mental health disorder. No one should be shy to look at the source of their sleep inadequacy, in the author’s opinion, as adequate sleep is crucial for quality of life, income potential, overall health, and peace of mind in relationships at work and at home. The other note about this graph is that different subtypes of insomnia exist as do varying levels of mental health. We want to build health with knowledge and minimize chronic disease with maximizing stress management, weight management and tobacco use minimization.
Food Medication Interactions.When we have multiple medications on board, it behooves us to check with a pharmacist, dietitian or rely on ourselves to learn what vitamins or minerals or side effects may be removed from or added into our daily needs when using a given drug. Many psychotropic medicines should be taken with regard to food, calcium, iron supplements, or citrus juices to maximize the effects of the medication dosage (Food-Medication Interactions, 2004 ). Simply asking a doctor, pharmacist or dietitian to provide side effect information in writing, along with the medicine can be helpful and comforting when beginning a new pill or treatment (Pronsky, 2004).
Here are a few additional tips and caveats to consider when thinking about how your intakes may be related to your quality and quantity of regular sleep.
Sleep. Simple lack of adequate, quality sleep will boost levels of the hormone, ghrelin, and can lead to food cravings. Monthly hormonal surges or changes can also lead to a deficit of sleep through mood swings, along with mental stressors, and lack of normal cues for intake of food and fluids. Basic warmed milk, possibly doctored with a little sugar, vanilla or other flavoring, can increase sleepiness through from trypotophan and serotonin production that leads to a sense of calm. Typically, any warm fluids can do this, so heated almond milk or your choice likely will suffice.
Energy Needs. Are you familiar with “you haven’t eaten for hours, you must be starving, eat up”, “better eat now or be hungry later”, “no time to eat, gotta work”? Much of our negative thinking presses us to forgo food and fluids until we have reached a hunger that equates with severe emptiness. Or you simply haven’t been hungry and until eating a little before bed, you find that you are ravenous. Can you relate?
Dietitians often recommend several small meals a day, with protein at each eating occasion, to those with a diagnosis of Diabetes. Good advice and nothing to balk at unless you really don’t choose to make time to consume energy from fluids or foods during the day. Sometimes it can be nearly impossible, unless you’ve brought some sort of nourishment along with you. Most people who struggle with waking with hunger and eating at night, subconsciously or by choice, have only eaten around 500 calories a day(Constain, 2000-2013), say a piece of pie and a glass of milk, and maybe a few glasses of water. This is probably diet mode. One solution would be to check your hunger before bed. If hunger calls you, mindfully limit your evening, post-workday consumption by beginning an eating occasion with a sit-down plan. Consume only until you are full, altering sips of fluid with bites of food during a 10 – 20 minute period. Another solution would be to work at keeping a little protein of some sort at bedside in a closed container. This way you will be less likely to enter the room with the refrigerator (kitchen) and begin a see-food diet. You can also I cover more of this with my clients.
Sleep-encouraging relaxation techniques include autogenic relaxation, progressive muscle relaxation, and visualization, which can also be assisted by yoga, stretching, massage, listening to music, Tai Chi, and low-level exercise if anxiety is a problem. Just listed are simple ways to bring about a calm mindset during your sleep hygiene time, 10-60 minutes before bed. A professional or physician specializing in sleep medicine would assist with the objective data collected by actograph recordings and sleep studies for those interested in more scientific work-up of themselves, which the author highly recommends.
Tobacco Use. According to the 2010 Centers for Disease control data, 21.3% of adults (12th graders, men and women as adults) of the United States population uses cigarettes and tobacco. Nicotine use and caffeine right before bed, like brightness of one’s laptop or desktop computer or cell phone can affect ability to gain your zzzzs. Looking on the bright side, 17.3% nationwide were smokers in 2010, but 52.7% stopped smoking for one or more days that year. It often takes several attempts at cessation to reduce quit or reduce use. Like alcoholic beverages, sensitivity varies; and it may be that last couple at home, in bed, or when you settle in for the evening that holds you up from falling asleep routinely.
While on the subject, illicit substance use has been extensively blogged about. Your self-observation and tracking of use before bed, without knowledge of any mental health diagnoses, could say a lot. Many should be aware that while pot can assist in getting to sleep for those with ADHD and other mental health diagnoses, the quality of REM sleep is significantly altered and quantity will replace quality to acquire adequately refreshing sleep. It is critical to keep a record of your sleep hours to get a real picture of what sort of sleep your body needs, not just how chill you feel over the next year. Alcohol also helps one get to sleep, but a few extra drinks gets one up several hours later and may be part of the middle of the night wakefulness.
Disease and Emotion.
Narcolepsy, Sleep Related Sleep Disorder (a parasomnia), and generalized anxiety can alter sleep, in addition to daytime mood swings (Talbot, et al, p. 39) that lead to extreme fatigue, perhaps from depression, use of elicit substances that alter mental health, certain medication side effects, and seasonal changes that may enhance depressive symptoms (Bashir, 2010).
In conclusion, absolutely everyone needs time to themselves each day. While we may have to advocate for this in a busy family, workplace or relationship, purposefully taking time twice daily for mindful re-focusing, can bring even the most efficient person to level ground. The same goes for working on sleep hygiene, defined as controlling all factors that precede or may interfere with restful sleep. Getting more shuteye regularly or taking a ten minute catnap, is known to increase control over cravings. The Department of Health and Human Services develops a listing of goals for Americans to work toward every ten years (Healthy People 2020, 2010). This decade, Health Services and Individual Behavior were included as part of overall health determinants (Healthy People 2020, 2010; see http://www.healthypeople.gov/2020/about/DOHAbout.aspx#biology). If we consider that health is our wealth, we may be more likely to look mindfully at what is driving our evening consumption and interfering with an adequate level of refreshment. Mindfulness, even that ten minute, eye-closed catnap, decisions to reduce our use of caffeine, alcohol or nicotine quantities, food and caloric fluids (quality and quantity) during our busy hours of the day, and seeking health care guidance about our mental and physical health allow each of us to feel more appreciated and fulfilled. Good zzzzzzzs to you.
References
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Costain, Lyndel, BSc, RD. Night Eating Syndrome (or Night Time Binge Eating Disorder).
Retrieved from http://www.weightlossresources.co.uk/eating_disorders/night-time-binge-eating-disorder.htm
Feelings of “SAD”ness Affect Many During Winter Months: Identifying and treating Seasonal Affective
Disorder. (2006). Nashville, Tennessee, US: Tennessee Department of Mental Health (TDMH).
Healthy People 2020. (2010). Department of Health and Human Services. Determinants of Health.
Retrieved from http://www.healthypeople.gov/2020/about/DOHAbout.aspx#biology
National Institutes of Health (NIH). Brain Basics. 2008. Retrieved from
http://www.ninds.nih.gov/education/brochures/Brain-Basics-Sleep-6-10-08-pdf-508.pdf
Pronsky, A. (2004). Food-Medication Interactions. (13th ed.). Birchville, PA: FOOD-MEDICATION
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Sanchez-Ortuno, M., Carney, C., Edinger, J. Wyatt, J.(2011). Moving beyond average values:
Assessing the night –to-night instability of sleep and arousal in DSM-IV Insomnia Subtypes. Sleep
(April 1): 34(4). 532-539. Retrieved from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3065264/
Sleep.com: All things sleep. Retrieved from
Talbot, L. S., Stone, S., Gruber, J., Hairston, I. S., Eidelman, P., & Harvey, A. G. (2012). A test of the
bidirectional association between sleep and mood in bipolar disorder and insomnia. Journal Of
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