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Insomnia Insomnia has been a diagnostic criterion for NES that has been present since its first mention in the scientific literature (Stunkard et al., 1955). More specifically, sleep onset and maintenance insomnia are often described as elements of NES (Allison et al., 2010). Sleep onset insomnia is defined as when a person has difficulty falling asleep. Sleep maintenance insomnia is when a person has difficulty remaining asleep, which can manifest as early and/or frequent awakening and problems falling back asleep once awake (Roth, 2007). Insomnia is often observed in individuals with NES but not necessarily in all cases. In Allison and colleagues’ (2008) item response analysis, sleep onset insomnia was a significant predictor of having a NES diagnosis. Birkevedt and colleagues (1999) found that night eaters woke in the night significantly more than a control group (3.6 awakenings per night vs. 0.3 per night). While individuals with NES were observed to have similar sleep onset, offset, and sleep duration relative to the control group, people with NES had significantly more nocturnal awakenings (p < .001) that occurred earlier in the sleep cycle (O’Reardon, Ringel, et al., 2004). Belief That One Must Eat in Order to Initiate or Return to Sleep The belief that one must eat in order to initiate sleep or return to sleep is often a central feature of NES, but is not necessarily required to receive the diagnosis. A person with NES will often describe high levels of anxiety if they are not able to have the food they desire through the evening or upon awakening in the night (Allison et al., 2004). A person with NES will believe that they will be unable to fall asleep or return to sleep without food, indicating a direct relationship between food intake and anxiety due to the insomnia (Allison et al., 2004). The Night Eating Questionnaire (NEQ) assesses this belief that one must eat in order to sleep. 8PDF Image | BRIGHT LIGHT THERAPY FOR late NIGHT EATING SYNDRome
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