An Examination of the Bidirectional Associations between Sleep Quality and Binge Eating Using Ecological Momentary Assessment

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Description

Binge eating (BE) is associated with impairments in psychosocial functioning and poor treatment response, and BE commonly occurs in at-risk populations including female adults. BE occurs transdiagnostically across the ED spectrum and maintains other ED behaviors (e.g., dietary restriction,... Show moreBinge eating (BE) is associated with impairments in psychosocial functioning and poor treatment response, and BE commonly occurs in at-risk populations including female adults. BE occurs transdiagnostically across the ED spectrum and maintains other ED behaviors (e.g., dietary restriction, purging). Thus, it is important to research factors that maintain BE over time. Research suggests that poor sleep quality (e.g., difficulty falling or staying asleep, restless sleep) could contribute to BE persistence due to potential bidirectional associations between sleep quality and BE and that negative affect (NA) and the time that BE occurs could explain the BE-sleep association. To extend this research, the current study used ecological momentary assessment (EMA) to examine 1) between- and within-person bidirectional associations between BE and sleep quality and 2) if momentary NA (assessed between sleep and BE) mediates and if the timing of BE moderates the within-person BE-sleep quality associations. For the current study, adults assigned female at birth (N=57) with recurrent BE (at least twice a week for the past three months) self-reported BE, sleep quality, and NA at baseline and over a 14-day EMA period. Hierarchical regression analyses found that higher BE severity at baseline significantly predicted lower sleep quality averaged over the EMA period (p=0.02) but was only approaching significance after controlling for baseline sleep quality and depression (p=0.06). Between-person aggregated BE severity over the EMA period was not significantly associated with aggregated sleep quality and sleep quality at baseline and aggregated was not significantly associated with aggregated BE severity or more frequent BE over the EMA period (p’s>0.05). Multilevel models found significant bidirectional associations within-person higher BE severity and poor sleep quality, such that higher BE severity predicted worse sleep quality later that night (p=0.03) and worse sleep quality predicted higher BE severity later that day (p=0.03). In contrast, poor sleep quality did not significantly predict an increased likelihood of BE and there were not significant differences in sleep quality between BE and non-BE days (p’s>0.05). Multilevel modeling also found that intermediate ratings of NA did not mediate the within-person associations between sleep quality and BE severity, sleep quality did not mediate the within-person association in which NA predicted BE severity, and BE timing did not significantly predict sleep quality or moderate within-person BE severity predicting poor sleep quality (p’s>0.05). This study was the first to use EMA to test the bidirectional associations between BE and sleep quality while also accounting for NA and BE timing. Results suggest that among AFAB adults BE severity may lead to worse sleep quality, independent of NA and BE timing, and worse sleep quality may lead to higher BE severity on days with BE, independent of NA. Findings from the current study support integrating interventions for sleep disturbances into treatments for BE-spectrum EDs. Show less

Details
Department

PSYC / Psychology

Title

An Examination of the Bidirectional Associations between Sleep Quality and Binge Eating Using Ecological Momentary Assessment

Institution

Illinois Institute of Technology

Creator(s)

Johnson, Nicole Kathryn

Advisor(s)

Haedt-Matt, Alissa A.

Date

2024

Description

Binge eating (BE) is associated with impairments in psychosocial functioning and poor treatment response, and BE commonly occurs in at-risk populations including female adults. BE occurs... Show moreBinge eating (BE) is associated with impairments in psychosocial functioning and poor treatment response, and BE commonly occurs in at-risk populations including female adults. BE occurs transdiagnostically across the ED spectrum and maintains other ED behaviors (e.g., dietary restriction, purging). Thus, it is important to research factors that maintain BE over time. Research suggests that poor sleep quality (e.g., difficulty falling or staying asleep, restless sleep) could contribute to BE persistence due to potential bidirectional associations between sleep quality and BE and that negative affect (NA) and the time that BE occurs could explain the BE-sleep association. To extend this research, the current study used ecological momentary assessment (EMA) to examine 1) between- and within-person bidirectional associations between BE and sleep quality and 2) if momentary NA (assessed between sleep and BE) mediates and if the timing of BE moderates the within-person BE-sleep quality associations. For the current study, adults assigned female at birth (N=57) with recurrent BE (at least twice a week for the past three months) self-reported BE, sleep quality, and NA at baseline and over a 14-day EMA period. Hierarchical regression analyses found that higher BE severity at baseline significantly predicted lower sleep quality averaged over the EMA period (p=0.02) but was only approaching significance after controlling for baseline sleep quality and depression (p=0.06). Between-person aggregated BE severity over the EMA period was not significantly associated with aggregated sleep quality and sleep quality at baseline and aggregated was not significantly associated with aggregated BE severity or more frequent BE over the EMA period (p’s>0.05). Multilevel models found significant bidirectional associations within-person higher BE severity and poor sleep quality, such that higher BE severity predicted worse sleep quality later that night (p=0.03) and worse sleep quality predicted higher BE severity later that day (p=0.03). In contrast, poor sleep quality did not significantly predict an increased likelihood of BE and there were not significant differences in sleep quality between BE and non-BE days (p’s>0.05). Multilevel modeling also found that intermediate ratings of NA did not mediate the within-person associations between sleep quality and BE severity, sleep quality did not mediate the within-person association in which NA predicted BE severity, and BE timing did not significantly predict sleep quality or moderate within-person BE severity predicting poor sleep quality (p’s>0.05). This study was the first to use EMA to test the bidirectional associations between BE and sleep quality while also accounting for NA and BE timing. Results suggest that among AFAB adults BE severity may lead to worse sleep quality, independent of NA and BE timing, and worse sleep quality may lead to higher BE severity on days with BE, independent of NA. Findings from the current study support integrating interventions for sleep disturbances into treatments for BE-spectrum EDs. Show less

Type

Dissertation

File type

application/pdf

Subject

Clinical psychology
Behavioral psychology
Behavioral sciences
binge eating
disordered eating
eating disorders
loss of control eating
sleep disturbances
sleep quality

Access

Restricted Access

Rights

In Copyright
http://rightsstatements.org/page/InC/1.0/

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