O'Reardon John P, Peshek Andrew, Allison Kelly C
Division of Mood and Anxiety Disorders, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA.
CNS Drugs. 2005;19(12):997-1008. doi: 10.2165/00023210-200519120-00003.
Night eating syndrome (NES) is an eating disorder characterised by the clinical features of morning anorexia, evening hyperphagia, and insomnia with awakenings followed by nocturnal food ingestion. The core clinical feature appears to be a delay in the circadian timing of food intake. Energy intake is reduced in the first half of the day and greatly increased in the second half, such that sleep is disrupted in the service of food intake. The syndrome can be distinguished from bulimia nervosa and binge eating disorder by the lack of associated compensatory behaviours, the timing of food intake and the fact that the food ingestions are small, amounting to repeated snacks rather than true binges. NES also differs from sleep-related eating disorder by the presence of full awareness, as opposed to parasomnic nocturnal ingestions. NES is of importance clinically because of its association with obesity. Its prevalence rises with increasing weight, and about half of those diagnosed with it report a normal weight status before the onset of the syndrome. The recognition and effective treatment of NES may be an increasingly important way to treat a subset of the obese population. Treatment of the syndrome, however, is still in its infancy. One clinical trial has reported efficacy with the SSRI sertraline. Other treatments, such as the anticonvulsant topiramate, phototherapy and other SSRIs, may also offer future promise.
夜间进食综合征(NES)是一种进食障碍,其临床特征为早晨厌食、晚上食欲亢进、失眠且醒来后夜间进食。核心临床特征似乎是食物摄入的昼夜节律时间延迟。白天前半段能量摄入减少,后半段大幅增加,以至于为了进食而干扰睡眠。该综合征可通过缺乏相关代偿行为、食物摄入时间以及食物摄入量少(相当于反复吃零食而非真正的暴饮暴食)与神经性贪食症和暴饮暴食症相区分。NES也与睡眠相关进食障碍不同,因为患者有完全的意识,而非睡眠相关的夜间摄入行为。NES在临床上很重要,因为它与肥胖有关。其患病率随体重增加而上升,约一半被诊断为此病的人报告在该综合征发作前体重正常。认识和有效治疗NES可能是治疗一部分肥胖人群的越来越重要的方法。然而,该综合征的治疗仍处于起步阶段。一项临床试验报告了SSRI类药物舍曲林的疗效。其他治疗方法,如抗惊厥药物托吡酯、光疗和其他SSRI类药物,可能也有未来前景。