The relevance of sleep and chronopsychology in understanding maladaptive behaviors in eating disorders: A narrative review

Background and aims: Circadian disruption and sleep-wake dysregulation have been increasingly linked to psychiatric conditions, yet their role in eating disorders and addiction-like maladaptive behaviors remains insufficiently examined in an integrative framework. This narrative review synthesizes evidence on chronotype, circadian misalignment, sleep features, and behavioral addictions across anorexia nervosa, bulimia nervosa, orthorexic tendencies, and night eating syndrome. Methods: Literature published between 1970 and 2025 was identified through PubMed, Google Scholar, and reference screening, focusing on chronobiological, sleep-related, neuroendocrine, and behavioral aspects of eating disorders. Results: Delayed sleep timing, eveningness preference, and insomnia symptoms commonly co-occur with disordered eating. Findings suggest overlapping mechanisms linking circadian dysregulation, sleep-related and compulsive, reward-driven behaviors, including binge eating and compensatory practices. Objective measures indicate alterations in sleep continuity, slow-wave sleep, and REM parameters. Neuroendocrine evidence further supports links among biological rhythms, appetite regulation, and sleep regulation. Preliminary chronotherapeutic interventions, such as light exposure and sleep phase modification, show promise but remain insufficiently tested. Overall, subclinical, clinical and emerging eating disorders remain underrepresented in chronobiological research. Discussion and Conclusions: Circadian misalignment may represent a clinically relevant and modifiable dimension underlying maladaptive eating behaviors. However, fragmented evidence and methodological limitations restrict firm conclusions. A structured research agenda is proposed to guide future integrative research.