Alexithymia is not related to severity of night eating behavior: a useful distinction from other eating disorders.

OBJECTIVE: Patients affected by Night Eating Syndrome (NES) complain of insomnia, mood, anxiety and overeating, which have all been linked to difficulties in dealing with emotions, but no research has examined the levels of alexithymia among NES patients. We compared the levels of alexithymia among samples of: NES patients, insomniac patients who do not eat at night, and a control group. METHOD: The study included 153 participants: 34 with NES, 47 with insomnia, and 72 in the control group. Half of the NES group was recruited in a weight and eating disorders center in Philadelphia and the other in a sleep disorders center in Bologna, Italy. Alexithymia was evaluated through the Toronto Alexithymia Scale (TAS). RESULTS: All groups scored in the normal range of the TAS. There was no relationship between alexithymia and the severity of NES. The insomnia participants reported the highest levels of alexithymia and NES patients the lowest. All NES patients' scores were under the clinical cut-off for alexithymia. DISCUSSION: These data differ from the high levels of alexithymia reported by the literature among patients affected by Binge Eating Disorder (BED), suggesting that abnormal diurnal and nocturnal eating patterns, even though they may share several symptoms, are distinct syndromes having different psychopathological pathways.

Nocturnal eating is part of the clinical spectrum of restless legs syndrome and an underestimated risk factor for increased body mass index.

OBJECTIVES: We aimed to investigate the prevalence of night eating syndrome (NES) in a large cohort of patients with restless legs syndrome (RLS). METHODS: Our cross-sectional study included 120 patients examined at the University of Bologna Centre for Sleep Disorders, Bologna, Italy, and met all four International RLS criteria for the diagnosis of RLS. Each patient underwent a semistructured telephone interview investigating demographic data and general health status, RLS features and severity, presence of excessive daytime sleepiness, and presence of NES. RESULTS: The sample included 37 men and 83 women with a mean age of 63.8±11.5 years. There were 31% of patients who reported episodes of nocturnal eating (NE); among them, 17% fulfilled the new diagnostic criteria for NES. Comparing RLS patients with and without NE, there were no differences in RLS features. However, RLS patients with NE were older (67.2±11.6 vs. 62.4±11; P=.038), were in a higher body mass index (BMI) range (27.7±3.8 vs. 26.1±4.1 kg/m2; P=.023), were taking more drugs for concomitant diseases (89% vs. 72%; P=.031), were more likely to report insomnia (40% vs. 23%; P=.041), and were using more hypnotic agents (37.8% vs. 19.3%; P=.050) and dopaminergic drugs (65% vs. 46%; P=.041). When comparing those RLS patients with NES diagnostic criteria and those without NES, no differences emerged in demographic, clinical, and RLS features; however, NES patients were in a higher BMI range (28.3±4.1 vs. 26.2±3.9kg/m(2), P=.037), were more frequently smokers (43% vs 17%; P=.027), and were more frequently using hypnotic agents (30% vs. 24%; P=.025). Lastly, no differences were found when comparing patients with a NES diagnosis and those with NE not fitting the diagnostic criteria for NES, except for a higher use of benzodiazepine drugs (BDZ) in this latter subgroup (29% vs. zero; P=.014). CONCLUSIONS: A nocturnal compulsion to eat seems to be an intrinsic part of the clinical spectrum of RLS manifestations and an odd risk factor for increases in BMI in RLS patients. However, it is still not clear if NE in RLS would fit in one of the two known categorized syndromes of NE (i.e., sleep-related eating disorder [SRED] or NES) or if it represents a different strictly RLS-related eating behavior.