Engagement in binge eating and fasting associated with poorer sleep quality in an online sample of adults.

Objectives: Both disordered eating and disturbed sleep represent significant threats to mental health. Accumulating evidence suggests that disordered eating behaviors and sleep problems co-occur. A majority of current research, however, has focused on these behaviors as components of eating disorder diagnoses, rather than investigating the independent associations of transdiagnostic disordered eating behaviors and sleep. The present study sought to examine fasting, binge eating, self-induced vomiting, laxative or diuretic misuse, and driven exercise as predictors of sleep quality complaints. Method: An online sample of 648 U.S. adults completed the Eating Disorder Examination - Questionnaire, the Pittsburgh Sleep Quality Index, and the Patient Health Care Questionnaire-2 as part of a larger parent study. Results: Results of a hierarchical linear regression revealed that, collectively, disordered eating behaviors predicted worse sleep quality [R2 = 0.30, F(7, 640) = 31.21, p <.001], and that both binge eating and fasting, but not other compensatory behaviors, accounted for unique variance in sleep quality after controlling for BMI and depression. Conclusions: Overall, findings suggest that transdiagnostic disordered eating behaviors are associated with sleep quality complaints. Improved understanding of the specific relationships between individual eating behaviors and sleep characteristics can help refine the identification of individuals at high risk for sleep disturbance and address the potential reciprocal influence of sleep quality on disordered eating behaviors. Plain English Summary: Both disordered eating and problematic sleep negatively impact mental health. Many times they occur together and it is likely that worse sleep may intensify disordered eating symptoms and vice versa. Previous research tends to be limited to assessing sleep based on the presence or absence of an eating disorder diagnosis, rather than exploring associations between sleep and different types of eating disorder behaviors, such as fasting, binge eating, self-induced vomiting, laxative or diuretic misuse, and driven exercise. Thus, the current study examined symptoms of eating disorders that may occur across different eating disorder diagnoses and how they relate to sleep quality complaints. Six hundred forty-eight adults completed online questionnaires related to sleep, eating, and depression. Results of the current study found that higher weight, depression, fasting, and binge eating were most strongly related to worse sleep quality. Eating disorder symptoms such as binge eating and fasting may occur across eating disorder diagnoses, suggesting the importance of examining eating disorder behaviors, rather than diagnoses only. Continued understanding of particular risk factors for sleep problems within disordered eating will help identify high risk individuals who may need additional support for both problematic eating and sleep. [ABSTRACT FROM AUTHOR]