0908 Sleep and Eating Disorder Behaviors in Children and Adolescents: An Intersectional Analysis

Abstract Introduction Poor sleep health, eating disorder behaviors, and body image concerns affect millions of children and adolescents across the US. However, research examining how these issues intersect remains limited, particularly for children from marginalized communities. This study examined associations between sleep problems and eating disorder behaviors with a focus on how these relationships vary across intersecting race-sex identities. Methods Using the 2022-2023 National Survey of Children's Health, we analyzed caregiver-reported responses from a nationally representative sample (mean age = 11.6 years; 48.8% females). Weighted logistic regression models assessed relationships between sleep health (sufficient sleep duration and consistent bedtime) and eating disorder behaviors across race and sex groups. Results Over one-third (35.5%) of children experienced insufficient sleep, with Black males (52.5%) and females (48.3%) showing the highest rates compared to the national average. Poor sleep health was more strongly associated with eating disorder behaviors than the reverse. Inconsistent sleep showed the strongest associations: more than double the odds of fasting (OR = 2.10) and binge eating (OR = 2.22), and 56% increased odds of body image concerns (OR = 1.56). Hispanic/Latine and Multiracial females demonstrated elevated risk across multiple eating disorder behaviors relative to White males. Conclusion Findings underscore the importance of intersectional approaches to understanding pediatric sleep and eating disorder behaviors. Results suggest sleep health may be an important intervention target, though longitudinal research is needed to establish temporal relationships and inform prevention efforts. Support (if any)