Picture this: tossing and turning at night, your mind racing with thoughts about gaining weight, and waking up tired every day. For many people with anorexia nervosa, this scene will seem familiar. Surprisingly, this topic has not yet received much attention from the medical community. And yet a quick online search reveals that many patients with this eating disorder talk about their sleeping problems and seek out advice on forums. Anorexia patients tend to already have drawn the short straw: they have an intense fear of gaining any weight and worry enormously because of this. They are not comfortable in their body, and may starve themselves or resort to other extreme measures to lose weight. This can end up becoming so serious that they risk serious illness or even losing their life. This review has found that having sleep issues will make the situation even worse. But the relationship between sleep issues and anorexia is a two-way street: anorexia may just also be the thing causing the sleep issues. This review dives deep into the last decade of research on the topic, discovering that anorexia patients can suffer from a wide variety of issues with their sleep. They may not be able to fall asleep, or when they do, they wake up often. Some have nightmares and others grind their teeth. Some sleep problems mess with the structure of their sleep, so they may not get the right amount of deep sleep that they need for their body’s and brain’s well-being. Researchers are even uncovering potential genetic links between anorexia and sleep regulation, as well as certain substances in the body that could be playing a role. What is more, the studies revealed that anorexia patients who make themselves vomit or use laxatives to lose weight suffer from sleeping problems more frequently and in a different way. It is a complex puzzle. The key take-away? Treating anorexia should also mean treating sleeping disorders. But the story doesn't end there: we need more research and attention for this topic. Better sleep might just mean the first step towards improved health and well-being for these patients.