Assessment of night eating syndrome and circadian-related characteristics among university students of Rawalpindi and Islamabad.

Abstract

Introduction: Non-communicable diseases are associated with lifestyle behaviors such as diet, meal timing, levels of stress, quality of sleep, and disruption of circadian rhythms. Night Eating Syndrome (NES) is an abnormal eating behavior characterized by eating at night and/or eating after the last meal of the day. NES may be associated with sleep disturbances and/or circadian-related characteristics. University students are particularly susceptible to the development of NES due to academic stress, irregular schedules, increased exposure to screens, and late nights.

Objective: This study aimed to determine the prevalence and severity of Night Eating Syndrome and to examine the relationships between Night Eating Syndrome and sleep-related characteristics, circadian-related characteristics (diurnal preference), and mood among university students in Rawalpindi and Islamabad, Pakistan.

Methods: A cross-sectional analytical study was conducted on 335 undergraduate university students at four universities in Rawalpindi and Islamabad using a multistage sampling method. Data were collected using structured questionnaires including sociodemographic questions, the Night Eating Diagnostic Questionnaire, and the Sleep, Circadian Rhythm, and Mood questionnaire. Data analysis was performed using SPSS Version 27. Descriptive statistics, one-way ANOVA, Welch's ANOVA with Games-Howell post-hoc comparisons, multiple linear regression, Fisher-Freeman-Halton exact test, and Pearson chi-square test were used, with significance set at p < 0.05.

Results: The Prevalence of Night Eating Syndrome was 6% (n = 18; 95% CI: 3.2-8.4%). Severity-based classification showed that 51.0% had normal scores, 26.3% had mild symptoms, 17.3% had moderate symptoms, and 6% met the NEDQ criteria for NES. There were significant differences between NES severity groups in Morningness and Good Sleep scores (p < 0.001), while there were no significant differences in Depressed Mood scores (p = 0.159). In adjusted regression models, NES status was significantly associated with Good Sleep scores, while sex was associated with Morningness and BMI was associated with Depressed Mood. BMI category was significantly associated with NES status (Fisher-Freeman-Halton exact test, p = 0.002) and NES severity (p < 0.001).

Conclusion: Night Eating Syndrome and related symptoms were present among university students, with increasing symptom severity associated with differences in Morningness and Good Sleep scores, while Depressed Mood did not differ significantly across severity categories. These findings suggest the possible significance of health promotion initiatives conducted through universities emphasizing good sleep hygiene, regular meal time and early identification of night eating symptoms.