The First Study Conducted on the Relationship Between Sleep and ARFID

Mahr et al. (2022) conducted the first study investigating sleep disturbances in relation to avoidant restrictive food intake disorder (or ARFID). ARFID is an eating disorder characterized by the restriction of food intake and variety without body or weight concerns. The authors recruited a sample of 71 children and adolescents (ages 7 to 18) with diagnosed ARFID who received care in the same partial hospitalization care program. Researchers administered a variety of questionnaires assessing sleep quality/problems, psychopathology, and academic problems, both to participants and to their parents. They also measured children’s BMI (body mass index) and the severity of their eating pathology. Researchers reported that over 73% of parents endorsed at least one type of sleeping problem in their children, and 83% of these children self-reported sleeping issues. The most common sleep problems endorsed were general difficulty sleeping, sleeping less than others, and experiencing nightmares. Sleep disturbances were associated with more academic difficulties, as well as more internalizing and externalizing psychopathology symptoms in ARFID patients. Parents of girls reported greater severity of nightmares and overtiredness, whereas parents of boys reported higher severity of bed-wetting. These results provide strong evidence of significant sleep disturbances in patients with ARFID, as well as the negative life impact of these sleeping problems. Additionally, the number and severity of sleep disturbances were not associated with patients’ BMI, suggesting that specific nutritional deficiencies in ARFID, rather than overall low body weight, may influence the relationship between ARFID and sleep problems. The authors conclude “The role of specific nutritional deficiencies, bio-regulatory systems, environmental factors affecting sleep including parenting practices, sleep hygiene, association with treatment response, and the degree to which nutritional recovery may ameliorate sleep disturbance in ARFID warrant further investigation.”

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