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Sleep Health in Bulimia Nervosa: A Systematic Review.

Samantha Kenny1,2, Malka Hershon1,2, Linda Booij3,4

  • 1Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada.

European Eating Disorders Review : the Journal of the Eating Disorders Association
|June 20, 2026
PubMed
Summary

This review found that while some studies report increased subjective sleep problems in bulimia nervosa (BN), objective findings are mixed. More research is needed to understand sleep disturbances in BN.

Keywords:
adultsbulimia nervosaeating disordersleep health

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Area of Science:

  • Sleep science
  • Psychiatry
  • Eating disorders

Background:

  • Bulimia nervosa (BN) is associated with varied and inconsistent sleep research findings.
  • Comorbid mood disorders may influence sleep disturbances in individuals with BN.
  • This systematic review was registered with PROSPERO (CRD42022354504).

Purpose of the Study:

  • To synthesize existing research on sleep disturbances in individuals diagnosed with bulimia nervosa (BN).
  • To investigate the potential role of comorbid mood disorders in sleep problems among BN patients.

Main Methods:

  • A systematic search of PsycINFO, Medline, and Scopus databases was conducted.
  • Included were quantitative studies comparing sleep in individuals with BN and healthy controls.
  • Methodological quality was assessed using a validated risk-of-bias tool.

Main Results:

  • Eleven studies met the inclusion criteria.
  • Subjective reports indicated greater sleep disturbance in BN (poorer quality, insomnia, daytime sleepiness).
  • Objective sleep findings were mixed, with inconsistent results for sleep efficiency and REM sleep.

Conclusions:

  • Subjective sleep disturbances are suggested in BN, but findings are heterogeneous.
  • Methodological limitations, including small sample sizes and cross-sectional designs, restrict conclusions.
  • Further research is necessary to accurately characterize sleep health in individuals with BN.