Inside Look

Dreaming of Healing: The Connection Between Sleep and Bulimia Recovery

bulimia recovery Jan 09, 2024

Many of us desire more quality sleep, a universal pursuit that becomes particularly challenging when navigating the complexities of bulimia.


Having personally faced this struggle and observed its prevalence among my private clients, I recognized the urgency of shedding light on the intricate relationship between bulimia and sleep. To comprehensively address this topic, I have combined my knowledge, experiences, and an exhaustive review of available research in one consolidated resource.


If you're new to our Conquering Bulimia blog, welcome! Merrit and I, both fully recovered from bulimia and bring our expertise as CCI Certified Eating Disorder Recovery Coaches. Through Sarah Lee Recovery and Merrit Elizabeth Recovery coming together, we have collaborated to offer an intense, self-paced course designed exclusively for bulimia: Conquering Bulimia. Our commitment extends to reaching and assisting as many individuals as possible on their journey to recovery, evident in resources like this blog.


Understanding Bulimia Nervosa:

Bulimia nervosa, a complex and pervasive eating disorder, is marked by episodes of uncontrollable overeating followed by purging behaviors, creating a multifaceted challenge for individuals. This disorder significantly impacts approximately 1% of the population over their lifetime. What distinguishes bulimia from other eating disorders is its ability to manifest across a spectrum of weight categories, affecting individuals who are underweight, of average weight, or overweight.


The hallmark of bulimia lies in the recurrent episodes of excessive food consumption, commonly referred to as binge-eating, which is then followed by compensatory behaviors aimed at eliminating the consumed calories. These purging behaviors may take various forms, such as self-induced vomiting, excessive exercise, or the misuse of laxatives. The diversity in weight categories among those struggling with bulimia underscores the complexity of this disorder, challenging common misconceptions that associate eating disorders solely with extreme thinness.


Unlike conditions where weight fluctuations are more predictable, bulimia's impact extends beyond physical appearance, permeating various aspects of an individual's well-being. The disorder poses a unique set of challenges as it can affect individuals who may outwardly appear to have a normal or even above-average weight. This diversity in presentation makes the identification and understanding of bulimia particularly nuanced, requiring a comprehensive approach to diagnosis, treatment, and support.


The broad range of weight categories affected by bulimia emphasizes the need for a holistic understanding of the disorder, moving beyond external appearances to consider the intricate interplay of psychological, emotional, and physiological factors. By recognizing bulimia as a complex challenge that transcends conventional expectations related to body weight, we can foster a more inclusive and accurate comprehension of this eating disorder, thereby facilitating improved awareness, diagnosis, and support for those grappling with its complexities.


Emerging Evidence:

The impact of eating disorders extends to over 30 million individuals in the U.S., with about 1 million (0.3% of the population) wrestling specifically with bulimia nervosa. While all eating disorders exact a toll on physical and mental well-being, recent evidence emphasizes a profound connection between bulimia and sleep. Recognizing this intricate relationship not only provides valuable insights for those struggling with bulimia but also unveils potential avenues for symptom alleviation through improved sleep.


Bidirectional Relationship:

Research highlights a bidirectional relationship between bulimia and sleep, suggesting that the disorder negatively influences sleep, and vice versa. Purging behaviors linked to bulimia contribute to worsened sleep quality and heightened daytime impairment. Additionally, individuals with bulimia tend to experience higher rates of short sleep duration, intensifying the severity of their condition.


Exploring the Links:

Various studies have identified compelling links between sleep and eating disorders, particularly bulimia. For instance, insomnia symptoms were prevalent in 25-30% of college-aged women diagnosed with eating disorders compared to 5% without. Long-term observational studies, spanning seven years and involving over 12,000 young adults, demonstrated that an eating disorder diagnosis predicted sleeping problems.



The impact of insufficient sleep on hormones plays a pivotal role in contributing to the urges to binge, a central aspect of bulimia. Ghrelin, often referred to as the "hunger hormone," rises with insufficient sleep, intensifying the drive to eat. Studies have consistently shown that inadequate or irregular sleep patterns lead to increased ghrelin levels, heightening the propensity for binge episodes in individuals with bulimia.


Leptin, known as the "satiety hormone," decreases with sleep disturbances, making it challenging to feel satisfied. Dieting, a common aspect of eating disorders, further decreases leptin levels, exacerbating the urge to mindlessly eat and engage in binge eating behaviors associated with bulimia.


Cortisol, termed the "stress hormone," is released in higher concentrations during periods of insufficient sleep and high stress. Chronic stress, often associated with bulimia, activates the sympathetic nervous system, inhibiting digestion and creating a cycle of stress-induced sleep problems. In the context of bulimia, this can lead to gastrointestinal discomfort, further propelling the perceived need to engage in purging behaviors.


Understanding these hormonal dynamics provides insight into the intricate interplay between sleep, hormones, and bulimia. The cycle of insufficient sleep, hormonal fluctuations, and disordered eating behaviors perpetuates the challenges faced by individuals dealing with bulimia.



The influence of sleep on mood cannot be understated, as chronic sleepiness becomes a significant catalyst for adverse mental health outcomes. The repercussions include an elevated risk for depression, heightened anxiety levels, and the cultivation of irritability. This intricate relationship between sleep and mood is particularly pronounced in individuals struggling with bulimia, where co-occurring mental health conditions are prevalent.


Research conducted by the National Institute of Mental Health sheds light on the pervasive nature of mental health challenges within the bulimia population. The findings reveal that a staggering 94.5% of individuals with bulimia nervosa experience an additional mental health diagnosis at some point during their lifetimes, with anxiety emerging as a predominant concern.


Bulimia, in itself, becomes a significant contributor to the restless and insufficient sleep experienced by individuals, thereby intensifying feelings of anxiety. The cyclic nature of this relationship creates a complex interplay of factors, wherein each element influences and perpetuates the others. The manifestation of bulimia-related anxiety not only disrupts sleep but is, in turn, exacerbated by the consequent sleep disturbances.


This intricate web of connections stress the need for a comprehensive understanding of the interdependence between insufficient sleep, anxiety, and bulimia. Recognizing this relationship is crucial for devising effective intervention strategies that address the multifaceted nature of these challenges. By acknowledging the cyclical pattern at play, healthcare professionals can tailor their approaches to simultaneously alleviate sleep disturbances, manage anxiety, and contribute to the overall well-being of individuals navigating the complexities of bulimia.



The relationship between eating disorder symptoms and nightmare frequency has been a subject of study. Individuals with eating disorder symptoms, including those with bulimia, exhibit a significantly higher incidence of nightmares compared to those without such symptoms. This phenomenon extends beyond general psychological distress, indicating a specific association between the symptoms of bulimia and the occurrence of nightmares.


Personal stories further illuminate the impact of nightmares on individuals struggling with bulimia. In instances of heightened stress nightmares can manifest as night terrors. These experiences, combined with the development of bulimia, can lead to the emergence of what I termed "food nightmares." Which I experienced often during my eating disorder. These nightmares, disturbing and vivid, mirrored the struggles of the waking hours and emphasized the pervasive nature of bulimia in both waking and sleeping states.


The resolution of these nightmares paralleled my journey into recovery from bulimia. As thoughts and behaviors associated with bulimia diminished, so did the frequency and intensity of food-related nightmares. The interconnectedness of mental health, sleep, and eating disorder symptoms highlights the importance of addressing these elements collectively in the recovery process.


Seeking Help:

Navigating the complex links between bulimia and sleep requires a multifaceted approach. Seeking professional help is instrumental, with counseling, particularly cognitive-behavioral therapy, serving as a cornerstone in addressing negative thought patterns associated with both bulimia and sleep disturbances.


Medications may be prescribed to alleviate associated mental health symptoms, providing additional support in managing the challenges posed by bulimia. The role of family, friends, and support groups is invaluable in reducing the stigma associated with bulimia and fostering a supportive environment conducive to recovery.


Improving Sleep for Bulimia Recovery:

Acknowledging the pivotal role of sleep in overall health, individuals contending with bulimia are empowered to take proactive measures to enhance the quality of their sleep. Establishing open communication channels about sleeping difficulties with healthcare professionals becomes a crucial initial step, paving the way for the development of personalized strategies for improvement.


Emphasizing healthy sleep hygiene practices becomes paramount in this journey. Cultivating a consistent sleep schedule provides a foundational structure, aligning the body with natural circadian rhythms. Creating a conducive sleep environment involves optimizing factors such as room temperature, lighting, and minimizing noise disruptions, fostering an atmosphere conducive to restful sleep. Incorporating relaxation techniques, such as mindfulness exercises or gentle stretching, further contributes to creating a calming pre-sleep routine.


For individuals dealing with the specific challenges of night eating syndrome, the exploration of light therapy emerges as a promising intervention. Light therapy involves exposure to a specialized lamp that mimics natural daylight, aiming to positively influence circadian rhythms. This targeted approach holds potential in alleviating sleep disruptions associated with night eating syndrome, thereby contributing to a more balanced and restorative sleep pattern.


By actively engaging in these proactive measures and incorporating tailored interventions, individuals with bulimia can cultivate an environment conducive to improved sleep quality. This comprehensive approach not only addresses the immediate challenges of sleep disruptions but also contributes to the broader spectrum of well-being for those navigating the complexities of bulimia.


In the pursuit of understanding the intricate relationship between bulimia and sleep, this comprehensive exploration dives into the nuanced interplay of physical, mental, and emotional factors. Rooted in personal experiences and informed by an exhaustive review of available research, this resource serves as a consolidated guide for individuals grappling with bulimia and those dedicated to supporting their recovery journey.


The complexity of bulimia nervosa, marked by uncontrollable overeating and purging behaviors, extends beyond conventional expectations related to body weight. It affects individuals across various weight categories, challenging preconceived notions and emphasizing the need for a holistic understanding. This nuanced approach allows for improved awareness, diagnosis, and support, recognizing bulimia as a multifaceted challenge that encompasses psychological, emotional, and physiological dimensions.


Emerging evidence sheds light on the profound connection between bulimia and sleep, emphasizing the bidirectional relationship that negatively influences both. Purging behaviors associated with bulimia contribute to worsened sleep quality, and insufficient sleep exacerbates the severity of the disorder. The exploration of these links provides valuable insights and potential avenues for alleviating symptoms through improved sleep.


The hormonal dynamics at play, including the impact on ghrelin, leptin, and cortisol, underscore the complexity of the interrelationship between sleep, hormones, and bulimia. This cycle perpetuates the challenges faced by individuals, creating a cascade of effects that influence disordered eating behaviors.


Mood, influenced significantly by sleep, becomes a catalyst for adverse mental health outcomes. Chronic sleepiness elevates the risk for depression and intensifies anxiety, creating a cyclical pattern where co-occurring mental health conditions are prevalent among those with bulimia. The interconnectedness of insufficient sleep, anxiety, and bulimia emphasizes the need for a comprehensive understanding to devise effective intervention strategies.


Nightmares, often overlooked, reveal a specific association between eating disorder symptoms, including bulimia, and increased nightmare frequency. Personal stories highlight the impact of nightmares on individuals, underlining the importance of addressing mental health, sleep, and eating disorder symptoms collectively in the recovery process.


Seeking help is pivotal in navigating the complex links between bulimia and sleep. Counseling, medications, and support from family and friends form a multifaceted approach to address negative thought patterns and alleviate associated mental health symptoms.


The proactive steps outlined for improving sleep quality in bulimia recovery encompass open communication with healthcare professionals, adopting healthy sleep hygiene practices, and exploring interventions such as light therapy. This holistic approach contributes not only to addressing immediate sleep disruptions but also to the broader well-being of individuals navigating the complexities of bulimia.


In conclusion, this resource serves as a comprehensive guide, shedding light on the interconnected struggles faced by individuals dealing with bulimia and sleep disturbances. By acknowledging the bidirectional nature of this relationship and adopting a multifaceted approach, there is hope for improved awareness, understanding, and support for those on their journey to recovery.


With Love & Light,

Sarah Lee

Sarah Lee is a Certified Eating Disorder Recovery Coach with four professional certifications, including one from the esteemed Carolyn Costin Institute. Since 2016, she has run a private practice currently located in Dallas, TX, assisting clients globally along with mentoring newer recovery coaches.

Posted on January 09th, 2024. 

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Harvard Health

HSPH Harvard

Your Hormones

Medical News Today


Research Gate

Pubmed NCBI 

Sleep Foundation


Psychiatry Online