Dietitian Lucy Carey explores the relationship between sleep and health. Can poor quality sleep contribute to eating disorders?

My eyelids were drooping but I was behind on my studies. Surely I didn’t actually need 8 hours of sleep… 6 hours would be fine… I could make it up on the weekend, right? I found my place in the textbook, opened my notebook, and gripped my pen.

I was 18 and had no idea of the impact sacrificing my sleep night after night would have. Like many researchers, I now believe that my lack of quality sleep contributed to disordered eating.

Sleep is absolutely vital for all living creatures to function. When humans are deprived of sleep for 24 hours, the effects on the body are the same as having a blood alcohol level of 0.10 – more than the legal driving limit.

After 48 hours, you may begin to hallucinate.

At 72 hours, delusions set in as you become more and more disconnected from your body.

At 96 hours, you don’t know what’s real and what isn’t. Sleep deprivation psychosis has taken over.

But that is continuous sleep deprivation and not likely to be a problem for people. What happens if you just don’t quite get enough sleep night after night after night? Like trying to live off 6 hours of sleep, instead of 7 or 8?

This is different to insomnia. In insomnia, you try to sleep but can’t. With persistent insufficient sleep, you can sleep, you just choose not to or your schedule doesn’t allow it. About 1 in 3 adults in the US report not getting enough sleep every night and it’s having disastrous health consequences.

Insufficient sleep has now been linked to 7 of the top 15 leading causes of death in the US.

Cardiovascular disease, cancer, stroke, diabetes, hypertension and car crashes, to name a few. In fact, people who sleep less than 6 hours a night are 10 times more likely to die an early death.

I think of it like borrowing money. Every hour of sleep you forgo increases your debt. If you continue night after night after night, soon you’ll be going bankrupt. Your ability to regulate emotions plummets and your judgement becomes impaired.

People with anxiety and depression are extremely likely to suffer from sleep disorders. But the big question is, which thing precedes the other? It’s a chicken and egg scenario.

Many researchers now think that mood disorders and sleep problems have a bidirectional relationship.

I strongly suspect it is the same with eating disorders. Not getting enough nutrients impacts brain function, including the production of hormones that control sleep. And sleep itself is involved in the production of hormones that control appetite.

For this reason, I ask all of my clients about their sleep. If they are not sleeping well it’s going to make everything worse, so I’ll put a few things in place to help:

• consistent sleeping times, even on the weekends
• dim the household lights an hour before bedtime
• have a consistent wind down routine each night
• a warm shower or bath in the evening
• chamomile tea
• keeping the bedroom fairly cool, dark and quiet
• no devices in bed
• focusing on relaxation instead of trying to force sleep

Often I find that simply by improving sleep, many of my client’s symptoms begin to improve. Add consistent meals and snacks to the equation and you’ve just ticked off the two things that have the most impact on recovery.