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Title

The Impact of Depression and Cognitive Dietary Restraint on the Association between Obstructive Sleep Apnea and Disordered Eating Behaviors

Creator

Schwartz, Natalie

Date

2020

Description

Obstructive sleep apnea (OSA) is characterized by loud snoring and repeated episodes of obstruction in the upper airway during sleep that...
Show moreObstructive sleep apnea (OSA) is characterized by loud snoring and repeated episodes of obstruction in the upper airway during sleep that cause partial or total stop in the airflow, often resulting in short, disruptive sleep. Sleep disruption as a result of OSA has been shown to result in reduced cognitive functioning and disordered eating behaviors, however, few studies to date have sought to determine whether OSA is associated with disordered eating behaviors. Bariatric patients are asked to restrict their food intake prior to surgery; however, restraint theory suggests that the eating behavior of those intending to restrict their intake can be disinhibited by a variety of conditions, which cause the restrained eater to engage in disinhibited and overeating behaviors. Depression has also demonstrated an association with disordered eating behaviors and cognitive dysfunction. Affect regulation theory is often cited as a possible explanation for this association, with the desire to avoid unpleasant affective states resulting in disordered eating behaviors. A sample of 93 bariatric surgery candidates were recruited from an academic medical center in a large metropolitan city to participate in the current study. Participants were recruited during their routine pre-surgical assessment for bariatric surgery and completed measures of disordered eating and depression. Both body mass index and diagnosis of OSA were obtained from patient medical chart. It was hypothesized that the presence of OSA would be related to higher levels of disordered eating behaviors, including disinhibited eating, frequency of loss of control and frequency of binge eating. Additionally, it was hypothesized that cognitive dietary restraint would moderate the association between OSA and disordered eating in bariatric patients, such that the greater the intent to strictly control food intake (i.e., greater cognitive dietary restraint), the more strongly sleep disturbance will be associated with disordered eating. Finally, it was hypothesized that depression would mediate the association between OSA and disordered eating in bariatric patients, such that depressive symptomatology accounts for the relation between OSA and disordered eating behaviors. Results indicated that the presence of OSA was not related to higher levels of disordered eating behaviors, nor did depression mediate the association between OSA and the disordered eating outcomes. Two of the moderation models were significant, including the disinhibited eating model and the frequency of loss of control over eating model. Although bariatric patients are encouraged to restrict their food intake, findings suggested that restraint does not appear to function as intended in reducing disinhibited eating behaviors in individuals with OSA. The findings for the loss of control model supported restraint theory and suggested that those with OSA who also endorse high restraint are at increased risk for experiencing loss of control over eating, whereas those who do not have cognitive dysfunction associated with OSA may or may not exhibit the same association. The current study highlights the impact of restraint on bariatric patients’ disordered eating behaviors, suggesting that restraint theory may not be entirely applicable to bariatric populations and may depend on the disordered eating behavior being examined. The current study also points to numerous gaps in the current literature and provides future directions for research on OSA and disordered eating in bariatric populations.
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