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

Abstract:

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-might be linked to sleep and treatment outcome in AN. Method: Fasting plasma orexin-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-(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 (= .026) but there were no global differences between groups in plasma orexin-concentrations (= .071). In the AN sample, orexin-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-concentrations and inadequate sleep pbkp_redicted poorer treatment outcome. Conclusion: Plasma orexin-concentrations contribute to poor sleep quality in AN, and both of these variables are associated with therapy response.

Año de publicación:

2016

Keywords:

• anorexia nervosa
• treatment outcome
• Sleep
• Partial hospitalization
• Orexin-A

Fuente:

scopus