Examining the Role of Insomnia in Maintaining Binge Eating and Restricting in United States Veterans

Objective: Eating disorders (EDs) and insomnia are prevalent among veterans. However, little is known about how ED and insomnia symptoms interact to maintain one, particularly in this population. We assessed associations between insomnia and ED symptoms (binge eating and restricting) for 6 months following military service separation. We hypothesised that: (a) greater insomnia symptoms would be associated concurrently with greater binge-eating/restricting symptoms across a 6-month period, and (b) the strength of the association between insomnia and binge-eating/restricting symptoms would be greater for individuals with ED vulnerability factors (i.e., body dissatisfaction, muscle-building concerns, depressed mood, and posttraumatic stress). Method: U.S. veterans (N = 833) completed ED, body dissatisfaction, muscle-building concerns, mood, post-traumatic stress, and insomnia symptom assessments at baseline, 1-week, 3-month, and 6-month follow-up. We used linear mixed-effects models to test hypotheses. Results: Greater insomnia symptoms were associated with greater binge-eating and restricting symptoms. Muscle-building concerns, depressed mood, and traumatic intrusion symptoms moderated the relationship between insomnia and binge-eating symptoms. None of the assessed ED vulnerability factors moderated the relationship between insomnia and restricting symptoms. Discussion: Given that greater insomnia symptoms were associated with greater ED symptoms among veterans, future research should explore potential causal pathways to inform ED treatment approaches.