Delayed circadian rhythms and insomnia symptoms in obsessive-compulsive disorder

Sep 3, 2022Journal of affective disorders

Late Body Clock Timing and Trouble Sleeping in Obsessive-Compulsive Disorder

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Abstract

Higher rates of delayed circadian rhythms and insomnia symptoms were observed in individuals with OCD compared to healthy controls.

Delayed circadian rhythms included higher eveningness and later mid-sleep timing.
Insomnia symptoms were more prevalent in adults with OCD than in healthy controls.
A correlation exists between delayed circadian rhythms and the severity of OCD symptoms across the sample.
Insomnia symptoms may mediate the relationship between delayed circadian rhythms and OCD symptoms.
No significant links were found between total sleep time or sleep quality and OCD.

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BACKGROUND: Accumulating evidence implicates sleep and circadian rhythm disturbance in obsessive-compulsive disorder (OCD). However, a multimethod characterization of sleep and circadian rhythms in OCD, their association with symptom severity, and the functional relationship between these variables is lacking.

METHODS: The present study measured multiple indicators of sleep and circadian rhythms in a sample of adults with OCD, adults without OCD, and healthy controls (n = 74). Participants completed measures of morningness-eveningness, delayed sleep-wake phase disorder (DSWPD), insomnia symptoms, and OCD symptoms, as well as one week of sleep monitoring via a sleep diary and actigraphy.

RESULTS: Delayed circadian rhythms (higher eveningness, later mid-sleep timing, and higher rates of DSWPD) and higher insomnia symptoms were observed in those with OCD compared to healthy controls, as well as associations between delayed circadian rhythms and insomnia symptoms and OCD symptom severity across the full sample. Further, insomnia symptoms mediated the relationship between delayed circadian rhythms and OCD symptoms. In contrast, there were no links between total sleep time or sleep quality and OCD.

LIMITATIONS: Data collection during COVID-19 pandemic, correlational data, no physiological measure of circadian rhythms.

CONCLUSIONS: These findings highlight a robust association between delayed circadian rhythms and OCD and suggest insomnia symptoms may be one mechanism in this relationship. Sleep and circadian rhythm disturbance may be novel targets for OCD treatment.

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Delayed circadian rhythms and insomnia symptoms in obsessive-compulsive disorder

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