Orexin and sleep quality in anorexia nervosa: Clinical relevance and influence on treatment outcome.

TitleOrexin and sleep quality in anorexia nervosa: Clinical relevance and influence on treatment outcome.
Publication TypeJournal Article
Year of Publication2016
AuthorsSauchelli S, Jiménez-Murcia S, Sánchez I, Riesco N, Custal N, Fernández-García JC, Garrido-Sánchez L, Tinahones FJ, Steiger H, Israel M, Baños RM, Botella C, de la Torre R, Fernández-Real JM, Ortega FJ, Frühbeck G, Granero R, Tárrega S, Crujeiras AB, Rodríguez A, Estivill X, Beckmann JS, Casanueva FF, Menchón JM, Fernández-Aranda F
Date Published2016 Mar
KeywordsAdult, Anorexia Nervosa, Case-Control Studies, Feeding Behavior, Female, Humans, Orexins, Sleep, Sleep Wake Disorders, Treatment Outcome

BACKGROUND AND AIMS: Orexins/hypocretins are orexigenic peptides implicated in the regulation of feeding behavior and the sleep/wake cycle. Little is known about the functioning of these peptides in anorexia nervosa (AN). The aims of the current study were to evaluate the extent to which orexin-A might be linked to sleep and treatment outcome in AN.METHOD: Fasting plasma orexin-A concentrations were measured in 48 females with AN at the start of a day hospital treatment and in 98 normal-eater/healthy-weight controls. The Pittsburgh Sleep Quality Index was administered at the beginning of the treatment as a measure of sleep quality. Other psychopathological variables were evaluated with the Symptom Checklist-Revised (SCL90R) and the Eating Disorder Inventory-2 (EDI). Patients were assessed at the start and end of treatment by means of commonly used diagnostic criteria and clinical questionnaires.RESULTS: The AN patients presented more sleep disturbances and poorer overall sleep quality than did the healthy controls (p=.026) but there were no global differences between groups in plasma orexin-A concentrations (p=.071). In the AN sample, orexin-A concentrations were associated with greater sleep disturbances (|r|=.30), sleep inefficiency (|r|=.22) and poorer overall sleep (|r|=.22). Structural Equation Modeling (SEM) showed that both elevated orexin-A concentrations and inadequate sleep predicted poorer treatment outcome.CONCLUSION: Plasma orexin-A concentrations contribute to poor sleep quality in AN, and both of these variables are associated with therapy response.

Alternate JournalPsychoneuroendocrinology
PubMed ID26741881