The Role of Sleep in Eating Disorder Recovery

Sleeping woman

“There does not seem to be one major organ within the body, or process within the brain, that isn’t optimally enhanced by sleep (and detrimentally impaired when we don’t get enough).”
— Matthew Walker, Ph.D., Author of Why We Sleep

Sleep may be the least talked about and most neglected resource we have when it comes to eating disorder recovery. Yet, the role sleep in eating disorder recovery plays is critical. But, when was the last time you heard a physician, therapist, or nutritionist inquire about your sleep habits or quality of sleep?

In his new book, Why We Sleep; Unlocking the Power of Sleep and Dreams, Matthew Walker, Ph.D., professor of neuroscience and psychology at the University of California-Berkeley, and the director of the Sleep and Neuroimaging Lab, outlines the critical role sleep plays in mental and physical health. [1]

On average, we need 8-9 hours of quality sleep each night. According to Walker, the benefits are significant:

  • Sleep improves our ability to learn, memorize, and make logical decisions and choices.
  • Sleep resets our emotional brain circuits and allows us to navigate our days with less anxiety.
  • Sleep restores our immune system, helping fight malignancy, preventing infection, and warding off all manner of sickness.
  • Sleep reforms the metabolic state by fine-tuning the balance of insulin and circulating glucose.
  • Quality sleep maintains a flourishing microbiome within the gut, a key ingredient for nutritional health.
  • Sleep is tied to healthy blood pressure and cardiovascular health.

Not getting enough sleep, or poor quality sleep creates havoc on our bodies which is why sleep in eating disorder recovery is so crutial.

  • Routinely sleeping less than six or seven hours a night devastates your immune system, more than doubling your risk of cancer.
  • Inadequate sleep disrupts blood sugar levels and contributes to diabetes.
  • Inadequate sleep disrupts the hormones responsible for hunger and fullness cues.
  • Sleep disruption contributes to all major psychiatric conditions, including depression, anxiety, and suicidality.

As you can see, getting enough quality sleep is critical to overall physical, emotional, and mental health. This fact often seems to be lost in many treatment settings where little thought is given to the sleep environment of patients. Sleep is disrupted by nightly monitoring, and they are routinely woken early in the morning for weights and vitals.

Are you getting enough sleep? SATED is a five-question self-assessment [2]. Answer the following five questions with a score of 0 (Rarely/Never), 1 (Sometimes), 2 (Usually/Always).

Lady waking up in the morning since Sleep in Eating Disorder Recovery is crucialSatisfaction: Are you satisfied with your sleep?
Alertness: Do you stay awake all day without dozing?
Timing: Are you asleep (or trying to sleep) between 2:00 and 4:00 a.m.?
Efficiency: Do you spend less than 30 minutes awake at night (This includes the time it takes to fall asleep and awakenings from sleep.)
Duration: Do you sleep between 6 and 8 hours per day?

Add up your score. A score of 0 is poor sleep. 10 is good sleep health.

So what can you do about sleep? Here are some tips on improving your sleep quality.

  1. Have a sleep schedule. Do the best you can to go to bed and wake up at the same time every day. Walker suggests setting an alarm, not for waking in the morning (if you are getting enough sleep, you will wake up naturally) but for going to bed at night.
  2. Avoid caffeine. If you do drink it, don’t do so after lunch. For just one cup of coffee or soda, as much as 1/2 of the caffeine can still be in your system even 7 hours later.
  3. Don’t nap after 3 p.m.
  4. Relax before bed. Leave time for your brain to unwind from the day. Don’t do stressful activities, such as paying the bills before going to sleep.
  5. Take a hot bath before bed. It will help you relax, and your body temperature will drop when you get out, preparing you for sleep.
  6. Quit using screens an hour before bed. The blue light from screens tells your brain to stay awake.
  7. Keep your bedroom dark, cool, and free from screens. Avoid having a digital clock in the bedroom, and if you awaken in the middle of the night, don’t check the time.

Walker writes, “Sleep is the single most effective thing we can do to reset our brain and body health each day.” Don’t neglect to incorporate quality sleep into your recovery plan.


[1] Walker, M. (2018). Why We Sleep; Unlocking the Power of Sleep and Dreams. New York, NY: Scribner.

[2] Buysse, D. J. (2014, January 1). Sleep health: can we define it? Does it matter? Retrieved December 16, 2019, from

About the Author:

Travis Stewart Headshot PhotoTravis Stewart, LPC has been mentoring others since 1992 and became a Licensed Professional Counselor in 2005. His counseling approach is relational and creative, helping people understand their story while also building hope for the future. Travis has experience with a wide variety of issues which might lead people to seek out professional counseling help.

This includes a special interest in helping those with compulsive and addictive behaviors such as internet and screen addiction, eating disorders, anxiety, and perfectionism. Specifically, he has worked with eating disorders since 2003 and has learned from many of the field’s leading experts. He has worked with hundreds of individuals facing life-threatening eating disorders in all levels of treatment. His website is

The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published December 24, 2019, on
Reviewed & Approved on December 24, 2019, by Jacquelyn Ekern MS, LPC

About Baxter Ekern

Baxter is the Vice President of Ekern Enterprises, Inc. He is responsible for the operations of Eating Disorder Hope and ensuring that the website is functioning smoothly.