Highlights

• Night eating is a common occurrence in shift workers due to irregularities in their work schedule
• Disturbance in the body's circadian rhythm, not having a meal plan and increased stress levels are all linked to night eating syndrome in shift workers
• It is associated with consuming greater than one-quarter of one's daily meal overnight and frequent night waking to eat
• Night eating syndrome can increase the risk of developing diabetes, digestive problems, and other health issues in shift workers
• Shift workers, as well as their employees, have contributions to make in managing night eating syndrome

Introduction

Has your shift work changed your eating pattern? Have you found yourself frequently eating at odd hours of the night during a shift duty? Then, you might have what is called night eating syndrome. Many shift workers experience this phenomenon even when they don't realise it. 

What is night eating syndrome?

Night eating syndrome, or nocturnal eating, is a feeding and eating disorder. It is a condition where you eat a lot of food at night, even after you have had dinner, or you wake up from sleep just to have another meal. There is always a strong feeling of the need to eat at night, and the feeling that without another meal, sleep may be difficult for you. This condition has a significant negative effect on sleep and places you at risk of developing health problems. About 1.5 in every 100 persons in the United States have night eating syndrome.¹ 

Who is a shift worker? 

Various organisations may have different criteria for what a shift worker stands for, the nature of the work schedule, and the compensation to receive. Typically, a shift worker is an employee who works beyond a normal schedule. Most people work the typical 9-to-5 job with breaks in between, but shift workers may work more hours with some form of compensation. Shift workers are found in organisations that offer uninterrupted services such as healthcare, safety and security services, manufacturing companies, stores, and emergency services. Shift work can be at night, during the day or on rotation. 

Link between shift work and night eating syndrome

In most organisations, shift work has become a necessity to maintain uninterrupted service provision. There is a link between irregularities in shift work and night eating syndrome due to the following reasons:

• Disturbance in the body's circadian rhythm – more than forty hours of work time is permitted in the United States in a week, thirty-seven hours a week in Denmark, and about thirty-five hours a week in France.² These hours are distributed for either morning, evening, or night shifts. This, in turn, affects the normal way your body regulates and controls when to go to bed, when to wake up, and when to eat within a twenty-four-hour period. This phenomenon is known as your body's circadian rhythm.² Most shift workers are awake when normally they should be asleep. This disturbance encourages food consumption at night and unhealthy snacking
• Not having a fixed meal plan – usually, people maintain breakfast, lunch, and dinner meal plans. Most shift workers do not have such meal plans. Even if they do, it is difficult to maintain due to rotation in their shifts.³ This lack of a plan leads to eating at odd hours, especially at night, and has been linked to night eating syndrome 
• Increased stress and tiredness –  some jobs are demanding and can increase stress in shift workers. Feeling tired during a shift, especially night shift, can make you eat more to keep up with the demands of the job

Signs and symptoms of night eating syndrome in shift workers

Shift workers who have night eating syndrome manifest the following signs and symptoms:

• Nighttime waking to eat becomes frequent
• Consuming more than one-quarter of what you should eat for a day overnight
• Increased appetite for carbohydrate-rich food or sugary foods at night
• The ability to remember everything you eat overnight when you wake up from sleep
• Missing breakfast
• Inability to perform your normal activities during the day

Health implications of night eating syndrome in shift workers

Shift work leads to changes in the meal plans of workers. Irregularities in shift work can cause you to eat at odd hours, especially at night. Night eating syndrome increases health risks in shift workers. Health implications that may arise include:

• Risk of developing diabetes, especially type 2 diabetes
• Excess weight gain
• Resistance to insulin
• Digestive problems
• Heart health problems

Other implications not directly linked to health include:^4,5

• Poor performance at work
• Increased tiredness
• Being absent from work
• Disliking your job
• Family problems due to inability to attend family meal time because of work
• Increased anxiety and depression

Strategies for prevention and management of night eating syndrome in shift workers

Here are practical steps you can take as a shift worker to prevent and manage night eating syndrome. Employers and organisations also have a role to play in this. 

Practical tips for shift workers

• Ensure to eat before the start of your shift. Your meal should include food rich in fibre and protein, such as beans, brown rice, fish, and almonds. Doing so keeps you feeling satisfied for an extended period and can prevent eating at night
• Choose healthy snack options. Instead of snacking on junk, choose peanut butter, fresh fruits, such as apples, or even prepare homemade fruit smoothies 
• Take more water, fewer sugary drinks, and avoid alcohol. You increase your calorie intake anytime you consume sugary drinks or alcohol. Water, on the other hand, improves digestion and keeps you hydrated. Always remember your water bottle when packing for your shift
• Coffee or tea can keep you awake longer than needed. Avoid it just before or close to your shift end time so you can have some sleep when you get home
• Have fixed meal times no matter the shift. Adhering to regular schedules helps your body's circadian rhythm adjust
• Feel free to express your concerns to your employer and find possible options that may suit you

Employers' role in the prevention and management of night eating syndrome

• Employers should promote a more stable working environment where workers have regular shifts. Having regular shifts helps you in planning proper meals and adjusting to the work routine
• Break time should be inculcated into every shift. This ensures employees have adequate time to eat and prevents unhealthy snacking
• Counselling units should be present and functional in every organisation to address issues related to increased stress levels and mental health in general
• Work-from-home options should be available if possible, and the work schedule should be flexible to enable employees to attend to personal and family issues
• Encourage health promotion in the workplace by providing nutrition counselling services

FAQs

What is the difference between night eating syndrome and sleep-related eating disorder?

Both conditions involve nighttime eating, but are not the same. In night eating syndrome, you decide what to eat, are fully aware of what is happening, and you can remember everything by morning. Whereas in a sleep-related disorder, you may not remember the night event, and may eat anything available.⁶ 

How can night eating syndrome be diagnosed?

Your healthcare provider will normally perform a physical assessment and may ask for your food diary. In addition, your eating pattern and sleeping habits will also be assessed. 

When should I seek professional help?

As a shift worker, night eating can increase your risk of developing health issues and also affect your output at work. It is crucial to discuss your health risks and concerns with a healthcare provider if your health and life quality are compromised. A nutritionist or dietitian will attend to you to address all your eating and health concerns and offer professional help. 

Summary

Shift work is gaining wide acceptance by most organisations due to the need to provide uninterrupted services. People who work shifts face various challenges, including adjusting to a routine for eating and sleeping. Irregularities in their jobs and the stress associated with them have resulted in the development of an eating disorder in most shift workers. This disorder is known as night eating disorder and is associated with many health implications. It is important to talk to your employer and visit a health facility when you think this is affecting your health.