Subjective sleep disorders and daytime sleepiness in patients with restrictive type anorexia nervosa and effects on quality of life: a case-control study.

Abstract Purpose To evaluate sleep disorders and daytime drowsiness in a cohort of patients affected by anorexia nervosa (AN) and their impact on health-related quality of life (HRQoL). Method We evaluated AN patients and healthy controls (C) by the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, Beck Depression Index. We also utilized the Short-Form Health Survey (SF-36) questionnaire to assess HRQoL in both AN and C. Results: Twenty-eight out of 34 AN patients (82.3%) had a pathological PSQI score while 10/34 (29.4%) healthy subjects (p<0.0001). The overall PSQI score was significantly higher in AN than in the controls (p=0.0004). The components sleep quality (p=0.008), sleep duration (p=0.03), sleep efficiency (p=0.004), sleep disturbances (p=0.01) and daytime dysfunction (p=0.002) were higher than C. SF36 showed significantly reduced scores of standardized physical components (p=0.01) and standardized mental components (p<0.0001) in AN, while physical function (p=0.0001), physical role (p=0.0005) and general health (p<0.0001), vitality (p=0.001), social functioning (p=0.0006) emotional role (p=0.002) and mental health (p<0.0001) were significantly decreased in AN. We found a significant correlation between the PSQI score and the physical role (r=-0.35, p=0.03) and education (r=0.38, p=0.02).Conclusion We demonstrated low sleep quality lacking subjective daytime sleepiness in AN. Sleep quality correlated significantly with HRQoL (physical role) and level of education. Level of evidence: level III case-control study