Unpacking anorexia and insomnia

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The connection between anorexia and insomnia is complex. Researchers haven’t identified precisely why there’s such a strong relationship between eating disorders and sleep. But they have pinpointed several links and believe they each influence the other.

In this article

Eating disorders and sleep

Not everyone who has problems sleeping has an eating disorder. And not everyone who has an eating disorder has problems sleeping. But eating disorders can disrupt sleep, and sleep disruptions can contribute to eating disorder symptoms. (1) Findings from several studies revealed:

  • 25%-30% of individuals diagnosed with eating disorders had insomnia symptoms, compared to 5% of those who didn’t have an eating disorder (2)
  • An eating disorder diagnosis was a predictor of sleeping problems (3)
  • More severe eating disorder symptoms were tied to sleeping problems (4)

Anorexia and insomnia

Some of the findings reported for sleep disruptions in those with anorexia include:

  • Lower quality of sleep, more disruptions in sleep, and less time spent in deep sleep and REM sleep (5)
  • Insomnia and early morning waking is associated with low body weight in anorexia nervosa (6)
  • Malnutrition in anorexia nervosa impairs brain function, including the production of hormones that regulate sleep, waking, appetite, hunger, and satiety.

But the reverse can occur, too, as the amount and quality of sleep a person gets impacts the production of these hormones, as well, and can, therefore, affect eating behaviors and food choices. (7)

Mental health disorders, such as anxiety and depression, can also contribute to the relationship between eating disorders and sleep. Between 40%-80% of people with anorexia nervosa and other eating disorders have a mood disorder. (8)

Why does anorexia cause insomnia? 

Food choices and quantities directly impact sleep patterns, because food contains the energy and nutrients the body needs to produce the hormones that regulate sleep. Not eating enough food results in the brain not getting enough energy to function properly and vitamin and mineral deficiencies that hinder the body’s production of hormones that regulate sleep. 

For example, iron, magnesium, and zinc are essential for getting a good night’s sleep. Patients with anorexia often have deficiencies in many vitamins and minerals, including calcium, iron, magnesium, Vitamins A, C, D, E, and K,and zinc deficiencies. A recent study found that people who slept less had lower levels of these nutrients. (6)

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Tips for stopping insomnia 

Getting a good night’s sleep and eating enough–and a variety of–food are essential for your whole health. 

Eating a variety of nutrient-rich foods every day can help improve your sleep and stop insomnia. Here’s a list of vitamins and minerals and foods that contain them:

  • Calcium: dairy products, salmon bones, sardines, green leafy vegetables, almonds, blackstrap molasses, broccoli, cabbage, carob, cheese, collards, dandelion greens, figs, goat’s milk, whey, yogurt
  • Magnesium: pumpkin seeds, almonds, spinach, cashews, peanuts, green leafy vegetables
  • Vitamin A: beef liver, liver sausage, cod liver oil, mackerel, salmon, bluefin tuna
  • Vitamin C: Kakadu plum, acerola cherries, rose hips, chili peppers, guavas, sweet yellow peppers, black currants, thyme, parsley, citrus fruits
  • Vitamin D: salmon, herring, sardines, cod liver oil, canned tuna, egg yolks, mushrooms (and sunlight) 
  • Vitamin E: wheat germ oil, olive oil, sunflower seeds, almonds, peanuts, peanut butter, beet greens, spinach, pumpkin, red bell pepper
  • Vitamin K: beef liver, green leafy vegetables, broccoli, spinach, cabbage, lettuce
  • Zinc: meat, shellfish, oysters, legumes, seeds, nuts, dark meat of chicken

Practicing what is called good sleep hygiene can help with insomnia, too. This includes:

  • Waking up and going to sleep at the same time each day, even on weekends
  • Winding down with a calming bedtime routine, such as reading, taking a bath or shower, or meditating
  • Stopping screen time at least 30 minutes before going to bed
  • Eliminating things that might disrupt your sleep, like your phone, loud noises, or bright lights
  • Having a comfortable mattress 

But the relationship between food, eating, and sleep is complicated. And the relationship between people who have eating disorders and food is even more complicated. 

When insomnia may be a sign of anorexia nervosa

For people who have anorexia nervosa, it’s not quite as easy as just eating more food so the body gets the nutrients it needs to function properly. Insomnia may be a sign of anorexia, which can have life-threatening consequences if left untreated for too long. But recovery is possible, and professional help is available.

Recognizing you or someone you love might need help is hard. But Within Health is here to help. Call our team today to learn about our first steps for treating eating disorders.

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Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Resources

  1. Allison KC, Spaeth A, Hopkins CM. Sleep and eating disorders. Current Psychiatry Reports. 2016 Oct;18(10):92. https://pubmed.ncbi.nlm.nih.gov/27553980/
  2. Aspen, V., Weisman, H., Vannucci, A., Nafiz, N., Gredysa, D., Kass, A. E., Trockel, M., Jacobi, C., Wilfley, D. E., & Taylor, C. B. (2014). Psychiatric co-morbidity in women presenting across the continuum of disordered eating. Eating Behaviors, 15(4), 686–693. https://pubmed.ncbi.nlm.nih.gov/25462028/
  3. Nagata, J. M., Thurston, I. B., Karazsia, B. T., Woolridge, D., Buckelew, S. M., Murray, S. B., & Calzo, J. P. (2020). Self-reported eating disorders and sleep disturbances in young adults: a prospective cohort study. Eating and Weight Disorders. 10.1007/s40519-020-00888-6. Advance online publication. https://pubmed.ncbi.nlm.nih.gov/32222955/
  4. Kim, K. R., Jung, Y. C., Shin, M. Y., Namkoong, K., Kim, J. K., & Lee, J. H. (2010). Sleep disturbance in women with eating disorder: prevalence and clinical characteristics. Psychiatry Research, 176(1), 88–90. https://pubmed.ncbi.nlm.nih.gov/20071034/
  5. Abdou, T. A., Esawy, H . I., Mohamed, G. A. R., Ahmed, H. H., Elhabiby, M. M., Khalil, S. A., & El-Hawary, Y. A. (2018). Sleep profile in anorexia and bulimia nervosa female patients. Sleep Medicine, 48, 113-116. https://pubmed.ncbi.nlm.nih.gov/29890462/
  6. Ikonte CJ, Mun JG, Reider CA, Grant RW, Mitmesser SH. Micronutrient inadequacy in short sleep: analysis of the NHANES 2005-2016. Nutrients. 2019 Oct 1;11(10:2335)
  7. Greer, S. M., Goldstein, A. N., & Walker, M. P. (2013). The impact of sleep deprivation on food desire in the human brain. Nature Communications, 4, 2259. https://pubmed.ncbi.nlm.nih.gov/23922121/
  8. Goel, N. J., Sadeh-Sharvit, S., Trockel, M., Flatt, R. E., Fitzsimmons-Craft, E. E., Balantekin, K. N., Monterubio, G. E., Firebaugh, M. L., Wilfley, D. E., & Taylor, C. B. (2020). Depression and anxiety mediate the relationship between insomnia and eating disorders in college women. Journal of American College Health, 1–6. Advance online publication. https://pubmed.ncbi.nlm.nih.gov/31971482/

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