O'REARDON, JOHN P., BRENDA L. RINGEL, DAVID F. DINGES, KELLY COSTELLO ALLISON, NAOMI L. ROGERS, NICOLE S. MARTINO, ALBERT J. STUNKARD. Circadian eating and sleeping patterns in the night eating syndrome. Obes Res. 2004;12:1789 -1796. 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 Ϯ 9.8 years; 32 women) and 43 similar controls (mean age 39.0 Ϯ 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 Ϯ 10.1% vs. 10.0 Ϯ 6.9%, p ϭ 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 Ϯ 1.0 per night vs. 0.5 Ϯ 0.5; p Ͻ 0.001), and their actigraphically monitored arousals occurred earlier during sleep (at 128 minutes after sleep onset vs. 193 minutes, p ϭ 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.

Sleep deprivation for one night has been investigated as a treatment for depression since the first publications describing its antidepressant properties almost 30 years ago [Pflug and Tolle, 1971: Int Pharmacopsychiatry 6:187-196]. It remains a field of active research. It is the only intervention consistently demonstrated to produce next-day antidepressant results. This makes sleep deprivation an exciting and unique tool to study the pathophysiology of depressive disorders and to formulate targets for novel antidepressant agents. Importantly, it is also an effective, but underused, clinical treatment for unipolar and bipolar depression.