Sleep disturbances in anorexia nervosa

ABSTRACT

In clinical practice, insomnia is a common feature in anorexia nervosa (AN). Sleep self-reports in AN suggest that these patients report poor sleep quality and reduced total sleep time. Weight loss, starvation and malnutrition can all affect sleep. Patients with eating disorders who have sleep disturbances have more severe symptomatology. The authors intend to review sleep disturbances observed in AN, describe possible pathophysiological mechanisms and evaluate the clinical impact of sleep disturbances on the treatment and prognosis of the disease. In this study, a non-systematic search of published literature from January 1970 and August 2015 was carried out, through PubMed, using the following key words: ‘sleep’, ‘anorexia nervosa’ and ‘insomnia’. These patients subjectively report having poor sleep quality, with difficulty falling asleep, interrupted sleep, early morning waking or reduced total sleep time. Sleep disturbances found in AN using polysomnography are: reduction in total sleep time, decrease in slow wave sleep, slow wave activity and reduced sleep efficiency. Privation of adequate and restful sleep has a negative impact on the quality of life of patients, may contribute to the appearance of comorbidities, such as depression and anxiety, and to a poor prognosis for AN.

KEYWORDS:

• Anorexia nervosa
• sleep
• polysomnography
• insomnia
• feeding behaviour

Acknowledgements:

The authors would like to thank to Ana Rita Carvalho from the Department of Psychiatry of Beatriz Ângelo Hospital for her contribution to the literature search and in the writing of the manuscript. They would also like to thank to Ana Mafalda Sousa Machado for her secretarial support during the literature research.

Disclosure statement

No potential conflict of interest was reported by the authors.