Why Sleep is So Important in Binge Eating Recovery

What does a good night’s sleep have to do with eating disorder recovery? More than one might think. The majority of individuals who have eating disorders report disturbed sleep. While sleep disturbance is a feature of all eating disorder diagnoses, it is also one of the most overlooked and important aspects of recovery. Research shows that addressing sleep issues throughout treatment may help improve recovery progress and quality of life, and decrease rates of relapse ^[1].

Your body’s clock – also known as circadian rhythms – is the natural cycle of physical, mental, and behavioral changes that the body goes through in a 24-hour cycle. These rhythms affect sleep patterns in addition to hormones, body temperature, and eating habits ^[2].

While good sleep offers many benefits to physical and emotional health, lack of sleep can negatively affect mood, appetite, and eating behaviors. Poor sleep hygiene makes it hard to maintain the quality of life that patients seek when they pursue treatment for eating disorders.

The link between sleep and eating disorders

Although many patients have sleep issues, they are so accustomed to sleep deprivation that they fail to mention sleep disturbance as an issue, unless directly asked by providers.

A study demonstrated that going to sleep at a later hour and/or having disturbed sleep throughout the night is associated with an irregular pattern of eating. The effects of chronic starvation in anorexia nervosa and fluctuating eating patterns in bulimia nervosa on the sleep- regulating processes have been recognized in sleep studies for more than 20 years; current data continue to confirm a strong correlation between sleep problems and eating disorders. Furthermore, patients who report poorer sleep quality show worsened outcomes from eating disorders ^[3].

Patients who have binge eating disorder and experience sleep deprivation often report one or more of the following:

• They have stronger cravings to eat between dinner and bedtime.
• They report increased cravings for highly processed and highly palatable foods.
• They find their cravings “impossible” to resist when fatigued.

These can all exacerbate the underlying tendency to binge. For those with anorexia, sleep deprivation can have the opposite effect and intensify food restriction. Another behavior seen in some sleep-deprived patients is engaging in eating-disordered behaviors instead of practicing self-care.

In one such case, observed by an ERC eating disorder specialist, a patient who reported sleep disturbances also had difficulty managing work and life stressors. When he finally stopped working for the night, feeling exhausted, he would want to “stay up and enjoy my only free time of the day.” He had abandoned many pleasurable activities as they seemed “too hard” when he was fatigued. He would then experience strong cravings for binge eating at night when he wanted to stay awake and relax. This patient became stuck in a vicious cycle of bingeing at night, which further disturbed his sleep and exacerbated the problematic cycle, causing it to reoccur each day.

Four ways to get better sleep

Because sleep is a behavior, it can be taught and modified. Begin with the following four steps:

1. Be consistent by setting sleep and wake times.

Determine the time that you will go to sleep and wake up each day. Stick to these times, even if you do not sleep well. Avoid sleeping later on weekends, as it will only further disrupt your sleep cycle. Try to keep sleep and wake times consistent within the hour, even on weekends.

What if you still can’t sleep? If you do have insomnia — even after setting consistent wake and sleep times — physically get out of bed if you have been awake for more than 10 minutes. Don’t turn to your cell phone or the TV; they produce enough “light” to keep your brain stimulated and awake, even when you are otherwise sleepy. Instead of a screen, read a book or magazine in dim lighting until you feel sleepy again, then return to bed. Repeat if needed.

Remember to be patient. It can take time to create good sleep habits and reset your circadian rhythms. Over time, if you are consistent with sleep habits, you should have fewer sleepless nights.

2. Understand how sleep affects your mood.

Improving your sleep habits can help improve your mental health. A recent study found that up to 94% of patients hospitalized for an eating disorder had a co-occurring mood or anxiety disorder, demonstrating how and why sleep should be a high priority ^[4]. Focusing on improving sleep quality will lead to fewer negative effects, more resilience, and better strategies for coping with life’s stressors.

3. Modify your morning behaviors.

When attempting to improve sleep, most people only focus on their nighttime routines. However, what you do in the morning is also crucial to improving sleep. Get out of bed immediately after your alarm wakes you up. Even if you are tired from the night before, pressing “snooze” will return you to a shallow sleep state that will leave you feeling less refreshed, and worse in the morning and throughout the day.

4. Seek professional help, if necessary.

If you are having trouble changing your sleep and eating habits, professional treatment may be necessary. In treatment, your therapist can work with you to evaluate, monitor, and modify your sleep and eating habits in the safety and comfort of a treatment setting.

Prioritize sleep. Give yourself the necessary energy to put toward your recovery and create a life worth living.

For more on this topic:

• Learn more about why you eat so much at night
• Get more tips on getting good sleep at night
• Binge eating disorder (BED) treatment