Sleep disturbances in anorexia nervosa subtypes in adolescence

Eat Weight Disord. 2021 Aug;26(6):1845-1852. doi: 10.1007/s40519-020-01033-z. Epub 2020 Oct 6.

Abstract

Purpose: This retrospective study investigated, for the first time, sleep characteristics in anorexia nervosa (AN) subtypes and the clinical profile in adolescents, as well as the quality of life (QoL) and emotionality in these patients with poor sleep.

Methods: The sample included 111 adolescents with AN. First, restrictive AN (ANR) and binge eating/purging AN (ANB/P) groups were compared in terms of self-reported sleep characteristics, sleepiness and chronotype. Second, the clinical profile, QoL, and emotionality of good sleepers (GS) and poor sleepers (PS) were compared.

Results: Compared to the ANR group, participants with ANB/P showed significantly greater sleep disturbances and sleepiness, and also a higher preference for an eveningness chronotype. Results also showed a clinical profile significantly more severe in PS than in GS. After adjustment, only the ANB/P subtype and the EDI-2 ineffectiveness subscale remained significantly linked to poor sleep. Moreover, the QoL was lower and emotionality more negative in PS with respect to GS.

Conclusion: Findings suggest that subjective sleep disturbances may be used as a clinical marker for AN severity and for ANB/P subtype. Importantly, findings suggest that improving sleep quality in adolescents with AN may help managing their ED and their comorbidities, but also improve their QoL.

Level of evidence: Level V, descriptive study (evaluation data retrospectively studied).

Keywords: Adolescent; Anorexia nervosa; Chronotype; Clinical marker; Sleep.

MeSH terms

  • Adolescent
  • Anorexia Nervosa* / complications
  • Humans
  • Quality of Life
  • Retrospective Studies
  • Sleep
  • Sleep Wake Disorders* / complications