In the Well section of this week’s New York Times, a reader asks the following: What’s the best food to eat just before bedtime if you get hungry? The questioner acknowledges beforehand that it’s not good to eat close to bedtime. The columnist answers by recommending specific food choices over others.
Not eating anything within 3-4 hours of bedtime is the single most important advice I give to all my patients, whether they come in for any ear, nose or throat problems (since I’m an ENT physician, or otolaryngologist). Since I also see mostly patients with obstructive sleep apnea, this advice is even more important, since apneas can literally suction up your normal stomach juices into your throat, aggravating throat swelling or making your tonsils and adenoids larger (if you still have them). In about 10 to 15% of patients, this is all that’s needed. No medications, no sprays, and no gadgets.
I once saw a 6 year old boy who was snoring at night with occasional breathing pauses, and regular bedwetting. His exam was typical for a child of this age with large tonsils and possible obstructive sleep apnea. His parents were reluctant to undergo a sleep study, so I recommended trying one thing: stop eating the ice cream every night just before bedtime. Six weeks later, his parents were ecstatic that his snoring and sleep quality was much improved, and his bedwetting was completely gone. Even his tonsils were smaller.
There are a number of conflicting studies and opinions on this subject. One commonly proposed reason why you SHOULD snack before bedtime is to keep your glucose levels stable. They argue that nighttime dips in your glucose levels can lead to arousals, hormonal imbalances, and even weight gain.
From my search on this topic on Google Scholar and Pubmed, although there’s no clear answer to this question, the vast majority of articles suggest avoiding eating close to bedtime. For example, this study found that asthmatics that eat close to bedtime suffer from more gasping, wheezing and reflux symptoms compared with those who eat earlier. Eating close to bedtime increased your chance of having acid reflux by more than 7 times those who eat earlier 3 hours before bedtime. Eating later was associated with being more overweight. Another study said the same thing. This study and this one showed much higher caloric intake in people who eat dinner later at night. Sleep restricted people gained weight, and became more hungry at night, leading to late night snaking.
I found one study suggesting that late night snacking actually helped people lose weight. However, upon looking at the original study, the participants were given breakfast cereal donated by Kellog to be eaten 90 minutes after dinner with a cup of milk. There was no mention of how close to bedtime they ate their cereal. The takeaway point was that eating cereal and milk after dinner lowered your cravings for snacks later at night, thus lowering total caloric intake.
Lastly, here’s a study showing that eating later in the evening was associated with memory problems, especially in the area of the hippocampus. This may be due to more reflux and more obstructed breathing, leading to less efficient sleep. We know that the hippocampus is damaged in patients with untreated severe obstructive sleep apnea.
So my answer to the reader on the NY Times’ Well blog is this: It’s not a matter of which food is better, it’s a matter of when should you stop eating at all before bedtime.
If you have other reasons why it’s better to eat close to bedtime, please let me know in the text area below.
If you’re still not convinced by my arguments, do this experiment for 4 weeks: If you normally eat dinner or snack just before bedtime, try eating at least 3 hours before bedtime. If you normally eat no later than 3 hours before bedtime, eat just before you go to bed. See how you feel at the end of the 4 weeks. How much weight did you gain or lose? Please make a note to comment back here in 4 weeks.
If you eat an early dinner, but get extremely hungry a few hours later, what can you do? Besides drinking some water, listen to an interview I did with Nutritionist Alyse Levine. She goes over what foods you can choose for dinner that can stave off those hunger pains later in the evening.