Staying Awake And Hungry: The Don't Eat, Don't Sleep Challenge

Not eating or sleeping can be a sign of night eating syndrome (NES), an eating disorder that happens alongside a sleep disorder such as insomnia. People with NES wake up several times a night to eat and may feel they cannot fall back asleep if they are not full. NES can affect a person's mood and ability to function during the day, and it can also increase the risk of health problems related to obesity. In extreme cases, not eating or sleeping can be a sign of suicidal ideation, as some people believe that depriving themselves of food and sleep will lead to death.

Night Eating Syndrome (NES)

NES is often linked to psychological, neurological, and genetic factors. It is also associated with a range of other disorders, including obesity-related complications such as diabetes, as well as other eating disorders, depression, anxiety, and substance use disorder. NES is estimated to affect around 1.5% of the population, or about 5 million people in the United States.

The exact cause of NES is unknown, but it is believed to be related to changes in the circadian rhythm, which regulates feelings of hunger, alertness, and tiredness. Treatment options for NES include cognitive behavioural therapy, antidepressant medications, progressive muscle relaxation, light therapy, melatonin, weight management programs, and hypnotherapy.

The symptoms of NES include:

• Waking up in the middle of the night to eat multiple times per week
• Eating a large proportion of daily food intake after dinner and before breakfast
• Craving high-calorie, high-carbohydrate, or sugary foods at night
• Lack of appetite in the morning, often skipping breakfast
• Difficulty functioning during the day due to lack of sleep

To be diagnosed with NES, individuals must overeat at night for at least 3 months, and the condition cannot be due to substance abuse, a medical disorder, medication, or another psychiatric issue.

Sleep and mental health

The Impact of Sleep on Mental Health

Research has shown that insufficient or poor-quality sleep can increase the risk of mental health disorders. Sleep deprivation studies have found that healthy people can experience increased anxiety and distress levels following poor sleep. Sleep deprivation can also increase the risk of suicidal ideation.

Sleep helps maintain cognitive skills such as attention, learning, and memory. Poor sleep can make it harder to cope with stressors and accurately perceive the world. It can also decrease positive emotions and increase negative emotional responses to stressors.

The Impact of Mental Health on Sleep

Living with a mental health problem can affect sleep in several ways. For example, anxiety can cause racing thoughts and worries that keep you awake, and you may also experience panic attacks while trying to sleep. Depression and seasonal affective disorder (SAD) can cause you to sleep more, including staying in bed longer or sleeping more often. Depression can also cause insomnia.

Trauma can cause flashbacks, nightmares, or night terrors that disturb sleep. You may feel unsafe or uncomfortable in bed or in the dark. Paranoia and psychosis may also make it difficult to sleep, as you may hear or see things that are frightening or disturbing.

Mania, often associated with bipolar disorder, can cause feelings of energy and elation, reducing the need for sleep. Racing thoughts can also keep you awake and cause insomnia.

Psychiatric medication can cause insomnia, disturbed sleep, nightmares, and oversleeping. Stopping psychiatric medication can also lead to sleep problems.

Improving Sleep and Mental Health

Addressing sleep issues can be an essential part of treating mental health disorders. Cognitive-behavioral therapy (CBT) is a type of counseling that can help improve sleep and mental state by examining and reformulating negative thoughts. CBT for insomnia (CBT-I) has proven effective in reducing sleeping problems and improving emotional well-being.

Improving sleep habits, such as maintaining a steady sleep schedule, winding down before bedtime, avoiding alcohol, tobacco, and caffeine in the evening, and getting regular exercise and natural light exposure during the day, can also positively impact sleep quality and mental health.

Sleep disorders

Sleep is a complex biological process that is critical to both physical and mental health. Sleep disorders are conditions that disturb normal sleep patterns, and there are over 80 types. Sleep-wake disorders often co-occur with other medical or mental health conditions, such as depression, anxiety, or cognitive disorders.

Insomnia

Insomnia is the most common sleep disorder, affecting about one-third of adults. It involves problems falling or staying asleep. To be diagnosed with insomnia disorder, sleep difficulties must occur at least three nights a week for at least three months, causing distress or problems at work or school.

Sleep Apnea

Sleep apnea is a breathing disorder characterised by interruptions in breathing during sleep, lasting 10 seconds or more. This can cause snoring, snorting, gasping, or breathing pauses. Sleep apnea is often linked to obesity and is more prevalent in men.

Restless Leg Syndrome (RLS)

RLS involves a tingling or prickly sensation in the legs, along with a powerful urge to move them. These symptoms occur in the evening or at night and are relieved by movement. RLS affects up to 3% of the population, typically beginning in the teens or twenties.

Hypersomnia

Hypersomnia is the inability to stay awake during the day and includes narcolepsy, which causes extreme daytime sleepiness. People with hypersomnia may sleep more than nine hours a day and still not feel rested.

Circadian Rhythm Disorders

Circadian rhythm disorders are problems with the sleep-wake cycle, causing an individual to be unable to sleep and wake at the right times. These disorders can be caused by internal or external factors, such as shift work or jet lag.

Parasomnia

Parasomnia involves acting in unusual ways while falling asleep, sleeping, or waking from sleep, such as walking, talking, or eating.

The impact of sleep loss

Sleep loss and sleep disorders are among the most common yet frequently overlooked and readily treatable health problems. Sleep is necessary to keep the central nervous system functioning properly, but chronic insomnia can disrupt how the body usually sends and processes information. Sleep deprivation can cause a range of health issues, including:

• Weight gain
• Weakened immune system
• Impaired concentration or learning new things
• Increased risk of accidents
• Mood swings
• Impaired decision-making processes and creativity
• Hallucinations
• Mania in people with bipolar mood disorder
• Microsleep
• Increased risk of chronic conditions, such as diabetes mellitus and heart disease
• Respiratory issues, such as obstructive sleep apnea (OSA)
• Increased risk of hypertension, diabetes, obesity, depression, heart attack, and stroke
• Impaired glucose tolerance
• Cardiovascular morbidity
• Adverse effects on mood and behaviour

Sleep and physical health

Impact on Overall Health and Well-being

Sleep helps keep your mind and body healthy. It allows your internal organs and processes to work throughout the night, servicing all aspects of your body, including molecular function, energy balance, intellectual function, alertness, and mood. A good night's sleep typically consists of 4 to 5 sleep cycles, each including deep sleep and rapid eye movement (REM) sleep, which is when we dream.

Weight Management

Getting adequate sleep can help maintain a healthy weight. Lack of sleep has been linked to weight gain and obesity. This is because your body releases hormones during sleep that help repair cells and control energy use, and these hormones can affect your body weight.

Cardiovascular Health

Sleep deprivation can increase the risk of heart disease and other cardiovascular issues. Throughout sleep, your heart rate, breathing rate, and blood pressure rise and fall, a process that is important for cardiovascular health. Sleep deprivation can lead to high blood pressure and an increased risk of heart attack and stroke.

Immune System

Sleep boosts your body's immune system. A lack of sleep can reduce your body's defences against diseases and infections. Research shows that well-rested people are better protected against illnesses like the flu, and they may also be at a lower risk of developing conditions like diabetes.

Safety and Accident Prevention

Being well-rested improves alertness and reflexes, reducing the risk of accidents. Drowsy driving, for example, causes thousands of car accidents annually. Similarly, fatigue at work can lead to a higher risk of work-related accidents and injuries.

Mental Health

Sleep deprivation can negatively impact mental health. It can impair higher-level functions like reasoning, problem-solving, and attention to detail. It can also influence your mood, increasing the risk of depression, anxiety, and irritability over time.

Lifestyle Factors

Lifestyle choices can significantly impact sleep quality and duration. Stimulants like caffeine and electronic devices that emit blue light can disrupt sleep. Maintaining a consistent sleep schedule, exercising regularly, and creating a comfortable sleep environment are essential for optimal sleep and, by extension, physical health.

Frequently asked questions