Self-reported eating disorders and sleep disturbances in young adults: a prospective cohort study

Abstract

Purpose To evaluate the prospective association between eating disorders, disordered eating behaviors, and sleep disturbances in young adults. Methods We used prospective cohort data of young adults aged 18–26 from the National Longitudinal Study of Adolescent to Adult Health (N = 12,082). Self-reported exposures of interest (at 18–26 years) included (1) an eating disorder diagnosis proxy; disordered eating behaviors such as (2) restrictive eating behaviors including fasting/skipping meals, (3) compensatory behaviors including vomiting, laxatives/diuretics, or weight loss pills; and (4) loss of control/overeating. Self-reported sleep disturbances at 7-year follow-up included trouble falling or staying asleep. Results In negative binomial regression models, all four exposures predicted both sleep disturbance outcomes at 7-year follow-up, when adjusting for demographic covariates and baseline sleep disturbances. When additionally adjusting for baseline depressive symptoms, the associations between eating disorder diagnosis proxies and trouble falling (incidence rate ratio [IRR] 1.24; 95% CI 1.05–1.46) and staying (IRR 1.16; 95% CI 1.01–1.35) asleep remained statistically significant; however, the associations between eating behaviors and sleep disturbances were attenuated. Conclusions Eating disorders in young adulthood predict sleep disturbances at 7-year follow-up. Young adults with eating disorders or who engage in disordered eating behaviors may be assessed for sleep disturbances. Level III Evidence obtained from well-designed cohort or case–control analytic studies.