Is sleep disturbance associated with treatment outcome among individuals with binge-spectrum eating disorders? A preliminary study

Enhanced Cognitive Behavioral Therapy (CBT-E) outcomes for binge-spectrum eating disorders (EDs) are suboptimal, thus new treatment targets should be identified. One potential target is sleep disturbance (i.e. increased sleep latency, decreased efficiency, duration, or quality) which may impact self-regulation abilities necessary for reducing binge eating. However, it is not yet known whether sleep disturbance predicts poorer outcomes from CBT-E. We examined the relation between pre-treatment sleep disturbance and treatment outcome among adults (<i>N</i> = 79; 84.81% White; 89.87% female) with binge-spectrum EDs receiving CBT-E. Multiple regression models examined the effect of sleep disturbance on both frequency of any loss of control (LOC) eating and objective binge episodes (OBE), and odds of remission from LOC and OBEs at post-treatment. Pre-treatment sleep efficiency was significantly negatively related to LOC frequency at post-treatment (<i>Est</i> = -5.807, <i>p</i> = .047). No other pre-treatment sleep characteristics were significantly associated with post-treatment LOC/OBE frequency or remission. ED diagnosis (bulimia- or binge eating disorder-spectrum) did not moderate associations of sleep disturbance with treatment outcome. Interventions aimed at improving sleep efficiency may merit testing in ED populations. Future research should assess whether changes in sleep efficiency during treatment are associated with increased reductions in binge eating at post-treatment.