Late and Instable Sleep Phasing is Associated With Irregular Eating Patterns in Eating Disorders

Abstract

Background Sleep problems are common in eating disorders (EDs). Purpose We evaluated whether sleep-phasing regularity associates with the regularity of daily eating events. Methods ED patients (n = 29) completed hourly charts of mood and eating occasions for 2 weeks. Locomotor activity was recorded continuously by wrist actigraphy for a minimum of 10 days, and sleep was calculated based on periods of inactivity. We computed the center of daily inactivity (CenDI) as a measure of sleep phasing and consolidation of the daily inactivity (ConDI) as a measure of daily sleep rhythm strength. We assessed interday irregularities in the temporal structure of food intake using the standard deviation (SD) of frequency (IFRQ), timing (ITIM), and interval (IINT) of food intake. A self-evaluation of other characteristics included mood, anxiety, and early trauma. Results A later phasing of sleep associated with a lower frequency of eating (eating frequency with the CenDI rho = −0.49, p = .007). The phasing and rhythmic strength of sleep correlated with the degree of eating irregularity (CenDI with ITIM rho = 0.48, p = .008 and with IINT rho = 0.56, p = .002; SD of CenDI with ITIM rho = 0.47, p = .010, and SD of ConDI with IINT rho = 0.37, p = .048). Childhood Trauma Questionnaire showed associations with variation of sleep onset (rho = −0.51, p = .005) and with IFRQ (rho = 0.43, p = .023). Conclusions Late and variable phasing of sleep associated robustly with irregular pattern of eating. Larger data sets are warranted to enable the analysis of diagnostic subgroups, current medication, and current symptomatology and to confirm the likely bidirectional association between eating pattern stability and the timing of sleep.

Inactograms and objective sleep measures as means to capture subjective sleep problems in patients with a bipolar disorder

“…36 We used the sleep detection algorithm introduced by van Hees et al 7 to process the actigraphy data as described in detail previously. 37 Sleep derived from accelerometry data was defined as inactivity associated with a low degree of arm angle changes (≤5 for ≥5 minutes).…”

The case for investigating a bidirectional association between insomnia symptoms and eating disorder pathology

“…It is likely that there is a bidirectional association between sleep and eating processes, such that eating pathology disrupts sleep and dysregulation in sleep influences eating behaviors (Linnaranta et al, 2020) and that this association is particularly problematic for people with EDs who may experience exacerbation and maintenance of ED pathology via dysregulated sleep. In the following paragraphs, we will discuss promising preliminary mechanisms underlying this bidirectional association (Figure 1).…”

Suicidal Ideation and Insomnia in Bipolar Disorders: Idéation suicidaire et insomnie dans les troubles bipolaires

“…Upon entry into the study (V1), all participants were outfitted with GENEActiv actigraphy devices (ActivInsights) for measurement of (in)activity and were instructed to wear the devices continuously for 2 weeks. Sleep variables were produced from actigraphy data (for detailed methods and validation see references [26][27][28] ). Briefly, Center of daily inactivity (CenDI) describes the mean direction of inactivity, measured as the daily distribution of sleep in radian angle of the sleep vector.…”

“…We also calculated onset, offset, and total duration of sleep as described previously. 26,27 The standard deviations (SDs) of the aforementioned variables were also calculated to describe the degree of their day-to-day variation.…”