As we all adjust to our new COVID-19 normal, sleep patterns have become collateral damage. Our new work -from-home/ stay-at-home schedules amplified by rising anxieties have altered how and when we rest. Some of us may find going to sleep harder or waking up much later because of more time we have on our hands. This disruption can wreak havoc on our mood, brain activity, and regulating hormones that are imperative to food choices and behavior. Getting sufficient and consistent sleep is a very important way of implementing self-care toward eating disorder recovery in this time of uncertainty and added stress.
Circadian Rhythm is our internal system for regulating sleep and is integral to our mood, eating behavior, and brain chemistry. When our normal sleep- wake cycle is disrupted, our circadian rhythm can be dramatically impacted which in turn affects our hormone release, eating habits and digestion, body temperature, and other important bodily functions. The NIH has reported that “irregular rhythms have been linked to various chronic health conditions and… mental health disorders.” (NIGMS.NIH.gov, 2020) As a result, those recovering from eating disorders are more sensitive to changes in sleep patterns. During the COVID-19 many folks have noticed their sleep and wake times have been compromised.
Changes to the circadian rhythm can also affect our mood by altering our serotonin levels. Serotonin is a neurotransmitter, a chemical that sends signals between your nerve cells, that plays an important role in mental processes such as mood and cognition and can also help with sleeping, eating, and digestion. Specifically, serotonin has been shown to regulate anxiety, happiness, and overall mood while low levels have been associated with depression. Serotonin is also responsible for stimulating part of the brain that controls sleep and waking.
Therefore it is no surprise that the densest serotonergic terminal in the brain is located at the primary circadian clock. Disruptions to our circadian clock mean disruptions to our serotonin levels, impeding our ability to regulate our mood and increasing our anxiety and risk of depression. “Alterations in brain serotonin function are thought to contribute to diverse aspects of eating disorders, including binge eating, perfectionism, impulsivity, and mood-regulation problems” (Steiger, J Psychiatry Neuroscience, 2004 Jan; 29(1):20-29). Being able to regulate our mood is critical in eating disorder recovery as our mood greatly affects our food choices and behaviors. As we are all trying to navigate this new normal and feeling a loss of control, by having our internal clocks confused can cause even more damage.
Normal serotonin levels will enable us to make thoughtful decisions about our food choices and meal patterns. When your sleep patterns change this can affect hunger and satiety cues. Serotonin also alters the hormones that regulate one’s appetite and satiety levels; leptin and ghrelin. Low levels of serotonin can increase hunger cues and a desire for high carbohydrate food. In a prospective cohort study of women found that disrupted eating patterns (having snacks over meals) were found in those with shorter sleep (<6 hours) and with longer (>10 hours) sleep (Kim, Public Health Nutrition, 2001; 14(5) 889-895). Other studies have found that sleep restriction impairs glucose metabolism, which increases a craving for sugary or more carbohydrate rich foods (Hanlon, PNAS, 2011; 108 (3):15609-16).
The amount of sleep and sleep patterns definitely affect our eating and is important to monitor when focusing on eating disorder recovery. Disruption can alter our natural serotonin balance, making it difficult to regulate our mood in an already challenging time, alter our hunger and satiety cues, and trigger different food cravings we may not be used to or comfortable with.
What to do to help adjust our sleep schedules:
Try to get back to a regular sleep and wake cycle by moving the waking and sleeping time back an hour every few days until they are back on schedule that aligns with your best health.
Trouble going to sleep? Create an evening ritual such as having a favorite drink or snacks, using aromatherapy oils or lighting candles, reading a book, taking a warm bath or shower, or journaling. Bedtime meditations can enhance relaxing and to calm our central nervous system (one of my favorite apps is Buddihify—has two sections one for going to sleep and one for trouble sleeping in the middle of the night)
Find yourself sleeping much later than usual? Try setting an alarm in the morning so that you get up at a reasonable time and get back to your usual schedule.