Sleep disturbances, night eating, and depression in patients with binge-eating disorder

Patients with binge-eating disorder (BED) frequently also meet the criteria for night-eating syndrome (NES). While both conditions are associated with elevated depression, it is less clear whether different features of night eating, including evening hyperphagia (EH) and nocturnal ingestions (NI), contribute to depression in individuals with a primary diagnosis of BED. Moreover, sleep disturbances, common in patients with BED, are also highly relevant for both NES and depression. Thus, using a sample of patients diagnosed with BED (N = 153), the present study examined the relationships between eating disturbances, including EH and NI, sleep disturbances, including initial insomnia (i.e., difficulty initiating sleep) and nocturnal awakenings, and depression. Initial insomnia, nocturnal awakenings, and EH were significantly associated with depression; NI was not. The results of a hierarchical linear regression showed that initial insomnia and nocturnal awakenings, but not EH, significantly contribute to depression, above and beyond global eating disorder pathology. Together, our results suggest that among patients with BED, in whom eating is already largely disrupted, EH and NI may not pose an additional risk for depression. In contrast, disrupted sleep does seem to confer a risk for depression, suggesting that a careful assessment of sleeping patterns in addition to eating patterns should be imperative in treatment-seeking patients with BED.