Because hormones that regulate appetite, food intake, and body weight also play a role in sleep regulation, patients with eating disorders often have associated sleep disorders. For example, obesity is related to obstructive sleep apnea (OSA)—weight gain is a risk factor for OSA, and weight loss often is an effective treatment. Moreover, patients with anorexia nervosa frequently demonstrate sleep initiation and maintenance insomnia.

Conversely, epidemiologic studies have demonstrated that sleep duration is inversely correlated with body mass index. In particular, individuals with shorter sleep times are more likely to be overweight. The nature of this association is unclear; however, hormones that normally regulate appetite are disrupted in patients with sleep deprivation. For instance, leptin is an appetite suppressant that is normally released from adipocytes during sleep, so sleep deprivation may promote hunger by restricting its secretion.

Michael J. Howell, MD
Minnesota Regional Sleep Disorders Center, Hennepin County Medical Center, Assistant professor, department of neurology

Carlos Schenck, MD
Minnesota Regional Sleep Disorders Center, Hennepin County Medical Center, Associate professor, department of psychiatry

Scott J. Crow, MD
Director, Clinical Populations/Assessment Core, Minnesota Obesity Center, Professor, department of psychiatry

University of Minnesota, Minneapolis

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