الفهرس 
Eating DisordersOnly 14 pages are availabe for public view
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Abstract
P
eople with psychiatric illness commonly complain of sleep problems, and sleep disruption is a part of the diagnostic criteria of many psychiatric disorders.
Among the several complications in eating disorders, patients tend to complain of physical disturbances, particularly of sleep disturbance.
Studies have shown that a significant number of patients with eating disorder experience sleep problems.
Causes of the high co-occurrence of the two disorders with different severity are quite complex, however could be explained by multiple theories.
First, the emotional features of eating disorder, such as anger, depression, and irritability, may explain these subjective sleep complaints.
Second, patients with sleep disturbance might suffer from behavioral disturbance more easily and frequently, since most patients are calorie deprived during the day and they have difficulty in controlling their eating behavior when they are alone in unstructured situations.
Third, disturbances in body and weight perception might show up in other somatic physiological complaints.
Fourth, comorbid depression can be frequently observed in eating disorders as sleep problems. However, most of the recent correlative analyses revealed no close associations between depressive symptoms and the sleep parameters evaluated in eating disorders.
Inspite of these important facts and their significant clinical implications, a very little number of studies were done exploring this phenomenon.
Aim of the study:
Based on that, this study was conducted aiming to study the profile of sleep in Eating disorders patients, determining the nature of the sleep disturbance in them if present and highlighting the factors related to this disturbance.
Subjects and Methods:
Accordingly, group of Eating disorders female patients at outpatient clinic at the Institute of Psychiatry, Ain Shams University who agree to participate in this study were included as case group.
Their age ranges between 20-40 years. Patients with Comorbid major physical illness or history of neurological diseases were excluded from the study. A control group of 20 healthy volunteers that age and sex matched with control group were included for comparison with cases.
The study took place from January 2012 till May 2014, All subjects of the study were assessed by using Structured Clinical Interview for DSM-IV (SCID I) diagnostic tool to diagnose Eating disorder and to exclude other Axis I diagnosis according to DSM VI classification.. Beck Depression Inventory (BDI): to assess the severity of depression state.
Comprehensive Sleep Disorder Questionnaire: To assess Personal sleep rituals as well as Sleep disorders which are insomnia, hypersomnia, parasomnias, or dyssomnias. All Night Polysomnography (PSG): to analyze the sleep architecture of the subjects including General sleep aspects NREM and REM sleep characteristics as well as assessment of respiratory variables during sleep.
Sleep assessment was performed when the participants were medication free for at least 7 days prior to study to exclude the effect of any psychotropic medication on their polysomnography.
Results:
The main findings in the study were highly significant differences between the two groups in most of sleep architecture variables (sleep efficiency, latency, stages percentages and REM sleep variables). No significant differences were detected regarding respiratory distress index, desaturation index, and periodic leg movement index.
There was lengthening of sleep latency, diminish of sleep efficiency, and significant rise of arousal index and this showed high statistically significant differences between cases and healthy controls.
The study shows that there was no significant difference in stage 1 but highly significant difference in stage 2 of NREM sleep in cases as compared to healthy controls, while stages 3 and 4 as well as SWS% were reduced. On the other hand, comparing REM sleep components of anorexic and bulimic patients to control subjects showed high statistically significant difference regarding REM % of total sleep time, REM density as well as density of 1st REM.
Using SSDQ, there were highly significant differences regarding difficultly falling asleep 56.5%, difficulty on Maintaining of sleep 47.8%, early morning awakening 21.7%, Disorder of Excessive Somnolence 21.7%, and parasomnias 39.1%.
Comparing patients with anorexia to those with bulimia showed no significant differences.
Discussion:
The findings of this study were similar to some of previous literature, emphasizing sleep changes in Eating disorders, and its correlates; explores sleep pattern in Eating disorder that to some extent especially in bulimic patients was different from sleep profile of depressed patients.
Several studies also applied a correlative approach. However, no consistent associations were found among the sleep patterns of eating disorder patients and the degree of body weight, the severity of psychopathology and the neuroendocrine as well as the morphological brain alterations due to the disturbed eating habits.
In general, these conflicting observations have to be related, at least in part, to the heterogeneity of the samples studied as well as to obvious methodological differences.