Waxing and waning: The roles of chronotype and time of day in predicting symptom fluctuations in obsessive-compulsive disorder using a daily-monitoring design

Aug 30, 2021Journal of psychiatric research

How sleep patterns and time of day relate to daily changes in obsessive-compulsive disorder symptoms

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Abstract

OCD symptoms fluctuate throughout the day, with eveningness preference associated with worse symptoms in the morning.

There is a relationship between chronotype and within-day fluctuations in OCD symptom severity.
Increased alertness may enhance inhibitory control, potentially reducing OCD symptoms.
Participants with an eveningness preference reported more severe symptoms in the morning compared to those with a morningness preference.
Sleep factors, including bedtime, sleep duration, and sleep quality, also impact OCD symptom severity the following day.
Overall, lower alertness is associated with more severe OCD symptoms throughout the day.

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Obsessive-compulsive disorder (OCD) symptoms fluctuate throughout the day, but scientists are not sure what underlies these fluctuations. One factor which may explain how OCD symptoms wax and wane throughout the day is alertness. Increased alertness is associated with greater inhibitory control, a factor which plays a significant role in patients' ability to overcome their OCD symptoms. The current study examined the relationship between chronotype (morningness/eveningness preference, a measure of alertness) and within-day OCD symptom severity fluctuations. We hypothesized that increased alertness leads to better inhibitory abilities and, therefore, reduced OCD symptoms. OCD Symptoms were measured through 7-days of monitoring in which participants were asked to retrospectively rate their symptoms at several timepoints throughout the day. Chronotype was measured using the Morningness/Eveningness Questionnaire (MEQ). Consistent with our hypotheses, results revealed an interaction between chronotype and time of day, such that those with an eveningness preference tended to have worse symptoms in the morning, and vice versa. In addition, we also report novel findings regarding the effect of bedtime, sleep duration, and sleep quality on symptom severity the next day. Taken together, these findings suggest that alertness may modulate OCD symptom severity throughout the day such that individuals experience more severe symptoms during times of low alertness. The clinical and theoretical implications of these findings are discussed.

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Waxing and waning: The roles of chronotype and time of day in predicting symptom fluctuations in obsessive-compulsive disorder using a daily-monitoring design

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