Delayed Bedtimes Are Associated With More Severe Obsessive-Compulsive Symptoms in Intensive Residential Treatment

Jun 27, 2020Behavior therapy

Later Bedtimes Are Linked to Worse Obsessive-Compulsive Symptoms in Intensive Residential Care

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Circadian Biology on OpenScience ↗PubMed ↗DOI ↗

Abstract

Delayed sleep phases were reported in individuals with severe obsessive-compulsive disorder (OCD), with later bedtimes associated with more severe symptoms.

Later bedtimes were linked to more severe OCD symptoms at both admission and discharge from treatment.
Sleep onset latency and sleep duration did not correlate with OCD symptom severity at admission.
There was no evidence that sleep behaviors influenced changes in OCD symptoms during treatment.
More severe OCD symptoms were associated with later bedtimes, indicating a bidirectional relationship.
The observed relationships between late bedtimes and OCD symptoms had a small effect size.

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Delays in behavioral and biological circadian rhythms (e.g., sleep timing, melatonin secretion) are found more frequently in individuals with severe and treatment-resistant obsessive-compulsive disorder (OCD). In recent years, it has been documented that these delays in behavioral and biological circadian rhythms are associated with more severe OCD symptoms and poorer response to some OCD treatments. This study examined self-reported sleep behaviors in individuals taking part in an intensive treatment for OCD and the relations between these and OCD symptoms (both at admission to and discharge from the treatment program). Replicating previous findings in less severe populations, delayed sleep phases were relatively common in this group and later bedtimes were associated with more severe OCD symptoms at admission. Sleep onset latency and sleep duration were not associated with OCD symptom severity at admission. Later bedtimes were not associated with self-reported depression or worry symptom severity. There was no evidence of sleep behaviors affecting change in OCD symptoms from admission to discharge from treatment-however, later bedtimes at admission were associated with more severe OCD symptoms at admission and discharge from treatment. There was no evidence of sleep onset latency or sleep duration having a similar predictive effect. More severe OCD symptoms at admission were also associated with later bedtimes at admission and discharge from treatment. These bidirectional predictive relations between late bedtimes and OCD symptoms were of small effect size but support the potential value of evaluating sleep timing in individuals with severe and/or treatment-resistant OCD.

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Delayed Bedtimes Are Associated With More Severe Obsessive-Compulsive Symptoms in Intensive Residential Treatment

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