Sleep disturbances in anorexia nervosa.
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| Title: | Sleep disturbances in anorexia nervosa. |
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| Authors: | Burger, Pia (AUTHOR), Bos, Rosita W. (AUTHOR), Maas, Joyce (AUTHOR), Simeunovic‐Ostojic, Mladena (AUTHOR), Gemke, Reinoud J. B. J. (AUTHOR) |
| Source: | European Eating Disorders Review. Mar2025, Vol. 33 Issue 2, p318-342. 25p. |
| Subjects: | Anorexia nervosa complications, Medical information storage & retrieval systems, Health status indicators, Sleep latency, Meta-analysis, Descriptive statistics, Systematic reviews, Sleep duration, MEDLINE, Anorexia nervosa, Sleep, Quality of life, Rapid eye movement sleep, Machine learning, Slow wave sleep, Confidence intervals, Sleep quality, Online information services, Sleep disorders, Weight gain, Pathological psychology, Algorithms, Sleep stages, Wakefulness, Psychology information storage & retrieval systems |
| Abstract: | Introduction: Sleep is crucial for physical and psychological health, and disturbances are closely linked to psychiatric disorders, making their management essential for improving treatment outcomes and preventing relapse. Although sleep disturbances are implicated in psychopathology of eating disorders, its role in anorexia nervosa (AN) remains unclear. This review aimed to characterise sleep in AN. Methods: A systematic search was conducted in four scientific databases, including papers from inception to 25 May 2024. A machine learning algorithm (ASReview) was utilised to screen titles and abstracts for eligibility. Sleep quantity, architecture, and quality were investigated. Meta‐analyses were conducted to investigate the difference between patients with AN and healthy controls (HC) in total sleep time (TST), wake after sleep onset (WASO), sleep onset latency (SOL), sleep efficiency, Sleep Stage 1, 2, slow wave sleep, rapid eye movement (REM) sleep and REM latency. Certainty of evidence was assessed using the GRADE approach. Results: Out of 67 potentially eligible papers, 31 were included in this review, with 15 in the meta‐analyses. Statistically significant average mean differences were found for TST (−32.1 min [95% CI: −50.9, −13.4]), WASO (19.0 min [95% CI: −2.4, 40.3]), and sleep efficiency (−4.4% [95% CI: −7.9, −0.9]). Additionally, Sleep stage 1 was significantly increased (2.4% [95%‐CI: 0.05, 4.7]), while REM sleep was reduced (−2.1% [95%‐CI: −4.2, −0.02]). Subgroup analysis showed that TST and WASO did not improve significantly after weight restoration. Conclusion: Sleep in patients with AN is impaired, with lower TST and sleep efficiency, higher WASO, more time in stage 1 sleep, and less in REM. Weight restoration alone may not improve sleep. While more research is needed, substantial accompanying sleep disturbances in AN justifies addressing these in current treatment practice, also because of the chronic character of AN and importance of sleep for long term (mental) health. Highlights: Patients with anorexia nervosa experience longer periods of wakefulness during the night, along with lower total sleep time and sleep efficiency compared to healthy controls.Patients with anorexia nervosa spend more time in stage 1 sleep and less time in rapid eye movement sleep compared to healthy controls.Weight restoration alone is not sufficient to improve sleep. [ABSTRACT FROM AUTHOR] |
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| Database: | Psychology and Behavioral Sciences Collection |
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| Abstract: | Introduction: Sleep is crucial for physical and psychological health, and disturbances are closely linked to psychiatric disorders, making their management essential for improving treatment outcomes and preventing relapse. Although sleep disturbances are implicated in psychopathology of eating disorders, its role in anorexia nervosa (AN) remains unclear. This review aimed to characterise sleep in AN. Methods: A systematic search was conducted in four scientific databases, including papers from inception to 25 May 2024. A machine learning algorithm (ASReview) was utilised to screen titles and abstracts for eligibility. Sleep quantity, architecture, and quality were investigated. Meta‐analyses were conducted to investigate the difference between patients with AN and healthy controls (HC) in total sleep time (TST), wake after sleep onset (WASO), sleep onset latency (SOL), sleep efficiency, Sleep Stage 1, 2, slow wave sleep, rapid eye movement (REM) sleep and REM latency. Certainty of evidence was assessed using the GRADE approach. Results: Out of 67 potentially eligible papers, 31 were included in this review, with 15 in the meta‐analyses. Statistically significant average mean differences were found for TST (−32.1 min [95% CI: −50.9, −13.4]), WASO (19.0 min [95% CI: −2.4, 40.3]), and sleep efficiency (−4.4% [95% CI: −7.9, −0.9]). Additionally, Sleep stage 1 was significantly increased (2.4% [95%‐CI: 0.05, 4.7]), while REM sleep was reduced (−2.1% [95%‐CI: −4.2, −0.02]). Subgroup analysis showed that TST and WASO did not improve significantly after weight restoration. Conclusion: Sleep in patients with AN is impaired, with lower TST and sleep efficiency, higher WASO, more time in stage 1 sleep, and less in REM. Weight restoration alone may not improve sleep. While more research is needed, substantial accompanying sleep disturbances in AN justifies addressing these in current treatment practice, also because of the chronic character of AN and importance of sleep for long term (mental) health. Highlights: Patients with anorexia nervosa experience longer periods of wakefulness during the night, along with lower total sleep time and sleep efficiency compared to healthy controls.Patients with anorexia nervosa spend more time in stage 1 sleep and less time in rapid eye movement sleep compared to healthy controls.Weight restoration alone is not sufficient to improve sleep. [ABSTRACT FROM AUTHOR] |
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| ISSN: | 10724133 |
| DOI: | 10.1002/erv.3148 |
