Later Bedtimes Predict Prospective Increases in Symptom Severity in Individuals with Obsessive Compulsive Disorder (OCD): An Initial Study

ABSTRACT

Prior studies of sleep in individuals with OCD have often focused on sleep duration. Several studies have found that individuals with OCD sleep less than healthy controls while others have failed to find significant group differences. Addressing sleep timing has been much more rare, but have consistently shown that many individuals with severe OCD in inpatient facilities had markedly elevated rates of disruptions in sleep timing. We extend prior work by testing prospective relations between sleep and OC symptoms in individuals representing a range of OC symptom severity. Twenty-six individuals diagnosed with OCD, 18 healthy controls, and 10 with subthreshold OC symptoms, completed seven days of sleep diaries and OCD symptom ratings. Results showed that sleep timing (later bedtimes) predicted prospective increases in both obsessions and compulsions in individuals with OCD but not the other two groups. In contrast, there were no significant effects of sleep duration. The significant effects of sleep timing in the OCD group were maintained controlling for depressive symptoms and OCD symptoms did not predict prospective changes in sleep timing. In conclusion, there is increasing evidence that sleep timing may play an important role in OCD and additional work in this area is encouraged.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

¹ Despite the small sample size for the subthreshold OCD group, we retained them in order to have a more complete distribution of OCD symptom levels. However, results particular to the subthreshold group should be interpreted with caution.

² Based on the suggestion from a reviewer, we also ran linear mixed models for obsessions and compulsions using midsleep time. Midsleep time was calculated using midsleep on free nights corrected for midsleep on work nights (MSFsc, see Roenneberg, Kumar, & Merrow, 2007). Midsleep is a good indicator of sleep timing as it is strongly correlated with melatonin profiles and does not confound timing of sleep and sleep duration. Results did not show a significant main effect or any interactions in predicting obsessions. However, when predicting compulsions, there were non-significant trends for the main effect of MSFsc and for an interaction of Group x MSFsc. Additional information is available upon request.

Additional information

Funding

This work was supported by the National Institute of Mental Health under award number F31MH100840 awarded to the first author.