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Sleep disturbances in anorexia nervosa.

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Title: Sleep disturbances in anorexia nervosa.
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]
Copyright of European Eating Disorders Review is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Sleep disturbances in anorexia nervosa.
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  Data: <searchLink fieldCode="AR" term="%22Burger%2C+Pia%22">Burger, Pia</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bos%2C+Rosita+W%2E%22">Bos, Rosita W.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Maas%2C+Joyce%22">Maas, Joyce</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Simeunovic‐Ostojic%2C+Mladena%22">Simeunovic‐Ostojic, Mladena</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Gemke%2C+Reinoud+J%2E+B%2E+J%2E%22">Gemke, Reinoud J. B. J.</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22European+Eating+Disorders+Review%22">European Eating Disorders Review</searchLink>. Mar2025, Vol. 33 Issue 2, p318-342. 25p.
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  Data: <searchLink fieldCode="DE" term="%22Anorexia+nervosa+complications%22">Anorexia nervosa complications</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+information+storage+%26+retrieval+systems%22">Medical information storage & retrieval systems</searchLink><br /><searchLink fieldCode="DE" term="%22Health+status+indicators%22">Health status indicators</searchLink><br /><searchLink fieldCode="DE" term="%22Sleep+latency%22">Sleep latency</searchLink><br /><searchLink fieldCode="DE" term="%22Meta-analysis%22">Meta-analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Systematic+reviews%22">Systematic reviews</searchLink><br /><searchLink fieldCode="DE" term="%22Sleep+duration%22">Sleep duration</searchLink><br /><searchLink fieldCode="DE" term="%22MEDLINE%22">MEDLINE</searchLink><br /><searchLink fieldCode="DE" term="%22Anorexia+nervosa%22">Anorexia nervosa</searchLink><br /><searchLink fieldCode="DE" term="%22Sleep%22">Sleep</searchLink><br /><searchLink fieldCode="DE" term="%22Quality+of+life%22">Quality of life</searchLink><br /><searchLink fieldCode="DE" term="%22Rapid+eye+movement+sleep%22">Rapid eye movement sleep</searchLink><br /><searchLink fieldCode="DE" term="%22Machine+learning%22">Machine learning</searchLink><br /><searchLink fieldCode="DE" term="%22Slow+wave+sleep%22">Slow wave sleep</searchLink><br /><searchLink fieldCode="DE" term="%22Confidence+intervals%22">Confidence intervals</searchLink><br /><searchLink fieldCode="DE" term="%22Sleep+quality%22">Sleep quality</searchLink><br /><searchLink fieldCode="DE" term="%22Online+information+services%22">Online information services</searchLink><br /><searchLink fieldCode="DE" term="%22Sleep+disorders%22">Sleep disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Weight+gain%22">Weight gain</searchLink><br /><searchLink fieldCode="DE" term="%22Pathological+psychology%22">Pathological psychology</searchLink><br /><searchLink fieldCode="DE" term="%22Algorithms%22">Algorithms</searchLink><br /><searchLink fieldCode="DE" term="%22Sleep+stages%22">Sleep stages</searchLink><br /><searchLink fieldCode="DE" term="%22Wakefulness%22">Wakefulness</searchLink><br /><searchLink fieldCode="DE" term="%22Psychology+information+storage+%26+retrieval+systems%22">Psychology information storage & retrieval systems</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: 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]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of European Eating Disorders Review is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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      – Type: doi
        Value: 10.1002/erv.3148
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      – Code: eng
        Text: English
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        PageCount: 25
        StartPage: 318
    Subjects:
      – SubjectFull: Anorexia nervosa complications
        Type: general
      – SubjectFull: Medical information storage & retrieval systems
        Type: general
      – SubjectFull: Health status indicators
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      – SubjectFull: Sleep latency
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      – SubjectFull: Meta-analysis
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      – SubjectFull: Descriptive statistics
        Type: general
      – SubjectFull: Systematic reviews
        Type: general
      – SubjectFull: Sleep duration
        Type: general
      – SubjectFull: MEDLINE
        Type: general
      – SubjectFull: Anorexia nervosa
        Type: general
      – SubjectFull: Sleep
        Type: general
      – SubjectFull: Quality of life
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      – SubjectFull: Rapid eye movement sleep
        Type: general
      – SubjectFull: Machine learning
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      – SubjectFull: Slow wave sleep
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      – SubjectFull: Confidence intervals
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      – SubjectFull: Sleep stages
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      – SubjectFull: Wakefulness
        Type: general
      – SubjectFull: Psychology information storage & retrieval systems
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      – TitleFull: Sleep disturbances in anorexia nervosa.
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              Text: Mar2025
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              Y: 2025
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