The impact of eating disorders on sleep and daytime functioning

Introduction: Sleep disturbances are commonly reported in patients with eating disorders. The aim of this study was to investigate the effects of eating disorders and body mass index (BMI) on sleep disturbances and daytime functioning. Methods: A survey was conducted among Dutch young adults (18 to 35 years old) to collect data on eating habits, sleep quality and sleep duration. Information on weight and height enabled computing of the BMI. The Eating Disorder Screen for Primary Care (EPS) and SLEEP-50 subscales on sleep apnea, insomnia, circadian rhythm disorder (CRD) and daytime functioning were completed. BMI, EPS, and SLEEP-50 scores were compared using correlational analyses. Subjects with eating disorders (EPS score > 2) were compared to those without eating disorders (EPS score <2). Results: N = 574 subjects (mean age 22.3 years old; 68.5% women) completed the survey. Only a few of the subjects met the SLEEP-50 criteria for insomnia (N = 9), sleep apnea (N = 1), or CRD (N = 3). N = 68 (11.8%) subjects were classiied as having eating disorders. Out of the total sample N = 14 (2.4%) of subjects reported having uncontrolled nocturnal eating episodes. Signiicant correlations were found between EPS scores and scores on insomnia (r = 0.158, p = 0.0001), sleep apnea (r = 0.131, p = 0.002), and daytime functioning (r = 0.249, p = 0.0001), but not for CRD (r = 0.07, p = 0.092). BMI scores only correlated signiicantly with scores on sleep apnea (r = 0.165, p = 0.0001). A clear difference in sleep disturbance scores was found between those with and without eating disorders. Subjects with eating disorders reported signiicantly higher scores on sleep apnea (2.9 versus 3.7, p = 0.011), insomnia (5.5 versus 7.7, p = 0.0001), CRD (2.3 versus 2.9, p = 0.009), and impairment of daytime functioning (5.8 versus 8.8, p = 0.0001) relative to subjects without eating disorders. Conclusion: Subjects with eating disorders commonly experience sleep disturbances and impairment of daytime functioning. The relationship between sleep disturbances and BMI was less clear.