The association between sleep and eating disorders in Canada before and during the first wave of the COVID-19 pandemic

Background: Sleep disturbances are prevalent among individuals with eating disorders (EDs), yet limited research has explored the interplay between EDs and sleep during the COVID-19 pandemic. This study aimed to compare 1) self-reported sleep quality before the pandemic (retrospectively) among individuals with current EDs, remitted EDs, and controls (no psychiatric history); and 2) sleep quality differences among these groups from before to during the pandemic. Methods: Participants (N = 1033) completed the Pittsburgh Sleep Quality Index and reported anxiety and depression symptoms for the month before the pandemic onset (retrospectively) and during the pandemic. One-way ANCOVAs compared sleep quality among groups before the pandemic, adjusting for anxiety and depression symptoms and demographics. Repeated measures ANCOVAs assessed sleep quality differences between before and during the pandemic, controlling for the same covariates. Results: Pre-pandemic, individuals with current EDs reported the highest sleep disturbance levels, followed by those with remitted EDs and controls (F (2, 955) = 11.01, p < 0.001). During the pandemic, sleep disturbance worsened across all groups, with individuals in current and remitted ED groups experiencing a more significant deterioration than controls, even when accounting for anxiety and depression symptoms (p < 0.05). Limitations: The cross-sectional design and retrospective self-reports of sleep quality. Conclusions: Individuals with current and remitted EDs seemed to be vulnerable to sleep disruptions during the pandemic. Sleep disruptions may persist during ED remission. Awareness of these dynamics can enhance mental health practitioners’ attention to sleep disruptions in adults with current or remitted EDs.