Sleeping With Disordered Eating: The Facts & Tips on How to Sleep Better
If you have trouble sleeping, it does not mean that you’ll develop an eating disorder. Likewise, if you struggle with food, you won’t necessarily experience a problem with sleep.
Yet, we do know that sleep and eating can be strongly interconnected. According to experts, there is a bidirectional relationship between the two. Evidence shows that individuals who are dealing with disordered eating may find that their sleep is negatively impacted by their behaviors. And, too, disturbances in sleep can exacerbate disordered eating symptoms. Science shows us a clear hormonal imbalance may occur if sleep is poor, and this may effect levels of hunger and satiety.
With this in mind, it can be critical to your overall recovery to consider how you’re sleeping. This bears true for disordered eating as well as other mental health diagnoses. Sleep is very important when it comes to overall wellness. If you aren’t sleeping well, the probability of good health, both physical and emotional, is reduced.
What Does It Mean To Have A Sleep Problem?
How do you know if you have a sleep problem?
Well, a problem can look like having a hard time falling asleep, finding you can’t seem to stay asleep, having trouble waking, feeling sleepy and sluggish during the day, or experiencing a behavioral disruption such as sleep walking.
When I work with someone, I will ask about sleep patterns. I may ask things such as:
How long do you sleep for?
What time do you go to bed and when do wake up?
Do you feel rested when you awaken?
Are you waking up during the night?
What Do We Know About Sleep and Eating?
Theories about the relationship between eating and sleep have been posited, and there has been research which highlights a disruption in appetite regulation hormones as a critical factor. Work remains ongoing and it is hoped that better understanding will ultimately lead to potential prevention and better treatment.
At present, some studies have shown staying up late can be related to problematic eating behaviors and negative effects on health. Does this mean it’s always bad to be a night owl? Not necessarily. But it’s worth considering how a tendency to be up late into the night could be contributing to your issues. Sometimes, being up late equates to getting less sleep overall, which we know has a tendency to increase hunger hormones while simultaneously reducing satiety.
When we get curious, we are more likely to find the problem - and finding the problem is necessary if we are to come up with potential solutions. It’s helpful to keep in mind that there is a difference between causation and correlation. But asking questions is a good place to start so that we might see probable causes while ruling other factors out. So we ask: what time do you go to bed? What symptoms are you experiencing? Could there be a connection? And could changing your bedtime make a considerable difference for you? Can we possibly try experimenting to see if going to bed earlier helps or not?
When it comes to disordered eating and sleep, it is generally acknowledged that a multifaceted and complex connection exists between the two. We can’t always say which may have occurred first – did you first have trouble sleeping and then your issues with food began? Or did you have difficulty with food, and then eventually your sleep became disrupted. We are so complex and such unique individuals, so both scenarios can be possible.
Research has, thus far, helped is learn the following:
A study, published in the international, peer-reviewed journal Eating Behaviors, involving 549 college-aged women found 25-30% of those who were with diagnosed with an eating disorder also experienced insomnia symptoms as compared to only 5% of those without eating disorders.
Reported in the scientific journal Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, researchers determined that a diagnosis of an eating disorder was predictive of sleeping problems. The observational study of over 12,000 young adults showed a statistically significant association between an eating disorder diagnosis and trouble falling and staying asleep. It was noted that eating disorders in young adulthood predict sleep disturbances at a 7-year follow-up.
Published in Psychiatry Research, “patients with sleep disturbance had more disturbing symptoms including higher binge frequency and vomiting frequency” and their response to treatment was worse.
An observational study published in BioPsychoSocial Medicine revealed that “purging behaviors, especially vomiting, might be related to . . . electrolyte abnormalities, or blood glucose level, which in turn can lead to disruptions in subjective sleep quality and sleep patterns. Thus, the sleep quality and patterns of patients with eating disorders might be vulnerable to purging behaviors, suggesting that treatments focusing on sleep would be useful.” The researchers reported that “patients with purging behaviors are more likely to exhibit disrupted sleep patterns, including circadian rhythm disruption and abnormal sleep duration, than are those without.”
Published in the journal Sleep Medicine, researchers completed a cross sectional study of sleep patterns in female patients, aged 18-45, with either bulimia or anorexia. The researchers found that “sleep and eating disorders are highly correlated.” It was found that patients experienced more sleep disruptions, worse sleep quality, and spent less time in restorative deep sleep.
Research, published in the International Journal of Eating Disorders, shows “significant associations . . . . between sleep problems (reports of not getting enough sleep, sleeping poorly, problems falling asleep, feeling sleepy during work or free time, and disturbed sleep) in individuals with binge eating disorder.”
What’s the Relationship Between Food, Sleep, and Mental Health?
Overall, the relationship between nutrition, sleep, and mental health is complicated. The good news is that researchers have made positive strides in understanding how each may influence the other.
For example, scientists have discovered the following:
Approximately 42% to 80% of those with an eating disorder are also diagnosed with a mood disorder such as depression and anxiety. These mood disturbances are known to impact sleep.
Malnutrition and insufficient nutrient consumption influences brain function including inhibiting the proper production of hormones which influence sleep and wake patterns. This can impact nightly sleep and may contribute to daytime drowsiness.
Sleep plays a key role in hormones which impact both hunger and satiety. When you sleep, levels of leptin increase and let your brain know that triggering hunger isn’t necessary. But if sleep is reduced? Then you end up with low levels of leptin and your brain will, as a result, tell you you’re hungry - even if you don’t need food in that moment. Compounding the issue is another hormone, ghrelin. When you aren’t getting sufficient sleep ghrelin increases. This results in your brain getting the message that it should stop burning calories and it makes you feel hungrier.
An upset in circadian rhythms, our internal clock that regulates when the body sleeps, wakes, and eats, can result in problematic eating patterns and may result in night eating syndrome, a disorder wherein individuals will consume an excess amount of food prior to bedtime or in the middle of the night.
What Can You Do If You Are Having Trouble Sleeping?
There are many different things you can do to improve your sleep. As with all things, this is not a one size fits all proposition. Some options might work wonderfully for you, and others might not be a good fit. You might need to experiment. You may find that there are multiple things you need to do in order to get better sleep - there usually is no singular magical fix, instead it’s often a combination of things.
Importantly, it helps to keep in mind that you’ll likely need to be consistent, committed, and persistent over the course of several weeks to see changes.
Here Are Some Ideas Which Could Help You Sleep Better:
Turn the Temperature Down
Ideal sleep temperature ranges from 55 to 74 degrees. It’s a wide range, and you can play around with your thermostat to find out which end of that is best suited to you. Most people find the upper 60’s to be perfect for snoozing. Keep in mind that while a warm room might seem cozy at first, particularly during chilly winter nights, if your room gets too warm (or too cold) you’re apt to keep wakening during the night. If you have the luxury of a programmable thermostat, you might want to start out cooler and then gradually increase as the night goes on.
Commit to a Set Wake up Time
It may seem like a good idea to take advantage of the weekend by sleeping in late, but sleep experts concur that this choice will likely work against you. It is actually better for overall sleep quality if you rise and shine at the same time everyday. Sleeping past your normal wake time can be disruptive to your circadian rhythm and you may find it harder to fall asleep at night if you sleep in.
Turn the TV and Phone Off
Nowadays it’s as if our phones are glued to our hands and our eyes are always on a screen. While most of us can’t get away from screens due to work and school obligations, all that screen time can wreak havoc on your sleep. Notably, the blue light that is emitted from the screens suppresses the production of the important sleep hormone melatonin.
To find out just how much screen time impacts us, and in what ways, researchers have been busy conducting studies. Interestingly, one study showed that people who used an E-reader before bed took an average of 10 minutes longer to go to sleep as compared to individuals who read from a traditional print book.
Other research has shown that staring at your phone pre-bedtime tends to make you more alert and less sleepy, even when you’re actively trying to go to sleep. Think about this - have you ever gotten that droopy eye feeling when you’re lying in bed reading a book, where you’re struggling to keep your eyes open and focused on the page? Yeah, the phone is apt to do the exact opposite of that. Yet another study demonstrated that participants who indulged in pre-sleep screen time reported feeling far more groggy in the morning as compared to those who had chosen a hard copy, old fashioned book as their bedtime companion.
It’s definitely a hard habit to break, but the results of giving up screens at night can be transformational. Try setting a time when all screens get shut off and put away. Commit to it and decide ahead of time what your alternative activity will be - maybe you talk with someone in your household (a nice traditional face-to-face chat), or you take a warm bath, or you do some reading, or you listen to some relaxing music.
As an alternative to looking away from the screen completely, some claim wearing blue light blocking glasses are helpful in combatting the circadian rhythm disruption. Some experts suggest that amber glasses are better suited to helping with sleep as compared to glasses with a clear lens. The one caveat with this is that there is no complete consensus on the efficacy of the glasses.
Many argue in favor of the glasses. However, ophthalmologists, in general, have indicated more research is needed - they state that clinical evidence to support the effectiveness remains lacking. In such a case, you might want to do your own research and/or try a pair out and see if you notice any difference.
Wear a Sleep Mask
The light sensitive cells in your retina communicate with your brain both day and night, so even a crack of light under your bedroom door, or the glow of a night light or clock, can upset your sleep. Wearing a sleep mask while you slumber can block out any extraneous light that might try to creep in.
One study demonstrated the efficacy of masks and researchers attested that a mask “not only improves subjective sleep quality, but also increases the amount of REM sleep and nocturnal melatonin levels.” Science does, in this case, support the option.
When purchasing, be aware of fit as a one size fits all option might not be ideal for you. A mask with an adjustable strap will allow you to change the size to what fits your head best. It should be snug enough so as to not slip off while you sleep. Also, a mask that is a bit thicker will keep out more light as compared to one made of a thin material. And a contoured mask with concave eye pockets can keep pressure off eyelids and allow for eye movement.
Cover Your Windows
Keeping with the idea of blocking disruptive light, hanging blackout curtains is another way to reduce whatever light may seep into your bedroom.
Give Caffeine a Curfew
Caffeine can take up to 12 hours to leave your system. So a late afternoon coffee or soda (even some chocolate or some over the counter medications) can keep you wide awake or make any sleep you do get seem less restful. It’s best to keep caffeine reserved for the morning. And if you feel the afternoon slump gets the best of you, try to get outside into natural sunlight for a short walk instead of reaching for a caffeine hit - it acts as a natural energy boost.
Nix Your Nap
Napping can be great, until it’s not. In some cases, such as if you’re dealing with depression or insomnia, for example, a nap may make things worse. If you have trouble sleeping at night, it can be very tempting to want to make up for the loss with an afternoon nap. However, this can just prolong and exacerbate the issue.
Let the Sun Shine
Exposure to more sunlight during the day, direct sun on skin, can help you sleep better at night. Sit outside for a break or go for a walk. The sun and fresh air can also benefit your mood and overall mental well-being.
Snuggle Under a Heavy Blanket
Weighted blankets have become more popular in recent years and serve as a sensory tool comparable to a soothing hug. While studies haven’t evidenced any major effects, individual reports have been favorable. That said, there is a caveat worth noting - conducting studies with a weighted blanket is particularly challenging as users will know whether or not such a blanket is being used. In other words, it is quite difficult to eliminate bias. But users have noted sleeping longer and waking up less during the night. Again, it’s yet another option to consider and could be worth trying.
Drink Up
Sipping on chamomile tea has been shown to calm muscles and the nervous system. Studies have been completed and researchers confirm the chemical structure does facilitate sleepiness in some people (and, of course, this means it might not work as well for others). Further, some other studies have suggested that effects are short term only and the results begin to decline after four weeks of use. So it might only be a briefly useful option. It’s recommended you drink the tea approximately 45 minutes prior to bed.
It’s critical to note that, whenever you are ingesting and supplementing with something, you should be mindful of any potential risks or side effects. Those who are allergic to daisies, ragweed, chrysanthemums, or marigolds should avoid chamomile. It’s also associated with a high risk for miscarriage or preterm labor - it is therefore not advised for use during pregnancy. Moms who are breastfeeding are also advised to take a pass as the depressant effect may lend to medical complications in the infant.
Overall, if you have any health conditions or allergies, or are taking any medications, it is vital to consult with a medical profession to avoid any harmful effects when using herbs (or any supplement).
Try Guided Imagery
Guided imagery is a type of focused meditation intended to promote calm. There are many audio recordings available, some free and some available for purchase. This mind body technique uses your senses, tapping into your imagination to lower stress and encourage sleep. It’s simple to employ and is an effective tool for reducing tension and bringing you into a more positive state of mind.
This is not an exhaustive list. Also, not every option will suit every person as we are unique individuals who respond differently to different things. Finally, be mindful of whether your sleep difficulties could be a symptom of a physical medical problem. If you make a good effort to get better rest, but your troubles continue for longer than four weeks, you may want to consult with a medical professional.