الفهرس 
Eating DisordersOnly 14 pages are availabe for public view
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Abstract
Summary
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.