2 - (SYM 101) Examining the Frequency of Sleep Disturbance Symptoms in Eating Disorder Samples with Co-occurring Post-traumatic Stress Disorder Symptoms vs. Eating Disorder Symptoms Alone

Eating disorders (EDs) are among the deadliest of all psychiatric disorders (Arcelus et al., 2011), with high rates of psychiatric comorbidity (Diagnostic and Statistical Manual of Mental Disorders [DSM-5], 2013). EDs and post-traumatic stress disorder (PTSD) frequently co-occur, with the prevalence of PTSD or experiencing trauma reported to co-occur in 20%-100% of ED samples (Ferrell et al., 2020; Mitchell et al., 2012). Further, sleep disturbances are strongly related to psychiatric illnesses (Freeman et al., 2020) and are a chief complaint in EDs (Cooper, Loeb, & McGlinchey, 2020) and PTSD (van Liempt, 2012). Subjective sleep disturbance may be a clinical marker for illness severity in ED (Bat-Pitault et al., 2020). The sparce research investigating sleep disturbances in EDs suggest that symptoms such as feeling tired connects to restriction, fasting, and binge eating, and loss of energy to loss of control overeating in anorexia nervosa and atypical anorexia nervosa (e.g., Ralph-Nearman et al., 2021). It is suggested that trouble falling or staying asleep and restricting from food may be illness pathways between PTSD and ED (Nelson et al., 2022). However, it is unclear if sleep disturbances are greater in those who endorse both PTSD and ED symptoms (relative to those with ED alone) particularly in an ED sample.
 

The current study (N=1147) consisted of three samples of participants ages 15 to 74 years (Mage=22.80; SD=8.27) with an ED who reported sleep disturbances (i.e., tired/fatigued, difficulty falling/staying asleep, nightmares, changes in sleep), PTSD symptoms, and ED symptoms (i.e., restriction, purging, binge eating, fasting, fear of weight gain, feeling fat).
 

Results show that only 27 (2.6%) participants with ED reported neither PTSD nor sleep disturbance symptoms. Overall, sleep disturbance symptoms co-existed more in those who endorsed co-occurrence of PTSD and ED symptoms (n=574, 57%) relative to those with only ED (n=434, 43%) (χ2 (2, N=1033)=32.04, p < .001).
 

This study adds to the dearth of research highlighting that sleep disturbances are common in those with an ED, though more research is needed to understand how sleep disturbances relate to and predict ED and other pathology. Importantly, this study suggests that sleep disturbances may be a key factor to treat in EDs and co-occurring PTSD. Next steps are to examine the inter-relationships among ED, PTSD, and sleep disturbance symptoms in ED.