3 - (SYM 101) a Network Analysis Investigation of Sleep Problems and Disordered Eating Among Military Members

Eating disorders and disordered eating affect a significant number of active-duty service members (SM) and Veterans (Gaviria & Ammerman, 2023; Mitchell et al., 2016). Sleep problems, such as insomnia and nightmares, are prevalent among current and former military members as well (Troxel et al., 2015). Notably, the majority of individuals with eating disorders experience sleep issues (Cooper et al., 2020), but to our knowledge no studies have examined this relation in a military sample.
 

Network analysis (NA) is a statistical tool that allows us to examine associations between different symptoms both cross-sectionally and longitudinally. Thus, in this study we used NA to examine between-subjects, contemporaneous, and temporal group-level networks of sleep and eating disorder symptom networks using a sample of SM and Veterans (n=100). Ninety-two participants completed a set of ecological momentary assessment (EMA) questions four times a day for 30 days. EMA questions asked about disordered eating symptoms (fear of weight gain, restriction, overeating, and shape/weight overvaluation) and sleep problems (worrying about sleep, sleep problems interfering with functioning, and nightmares interfering with functioning). Analyses were run using R Studio v4.1.2. In both the between-subjects and contemporaneous networks, worrying about sleep and fear of weight gain had the first and/or second highest expected influence.
 

The temporal network revealed that sleep problems and disordered eating symptoms clustered into two clusters. Additionally, overeating positively predicted nightmares interfering with functioning. Further, all symptoms had feedback loops and thus reinforced themselves over time. These results are consistent with findings that disordered eating is related to sleep problems in civilian samples.
 

Notably, assessment of eating habits among SM and Veterans with nightmares may be warranted and helping to reduce overeating could help reduce nightmares.