The Association Between Disordered Eating and Sleep in Non-Clinical Populations-A Systematic Review and Meta-Analysis

Sleep and disordered eating behaviours may be linked through physiological and psychological mechanisms; yet, no review has systematically investigated the relationship between different sleep indicators and disordered eating behaviours and cognitions outside a clinical context. The present systematic review and meta-analysis addressed this research gap to gain a better understanding of associations in non-clinical populations to potentially inform future prevention and early intervention approaches in the context of both sleep and disordered eating. All studies published from 2003 onwards were included if they assessed a relationship between disordered eating and sleep in a non-clinical population. In total, 89 studies were included, of which 33 met eligibility criteria for the meta-analyses. General eating pathology, loss of control eating, and excessive exercise were most consistently significantly associated with poorer sleep quality and higher insomnia symptoms, while evening chronotypes were most consistently associated with bulimia symptoms, night eating, and body image concerns. Likely due to the limited evidence available, findings relating to restrictive eating behaviours and bulimia symptoms were largely mixed. Primarily small and non-significant effects were found for associations between disordered eating and sleep duration measures. Overall, this review identified a need for more longitudinal research, the use of validated assessment methods, and studies focusing on restrictive eating, bulimia-related behaviours, and excessive exercise. Despite the heterogeneity of study populations and designs, this review highlights sleep problems (e.g., insomnia symptoms, impaired sleep quality) as a transdiagnostic correlate of disordered eating concerns.