Does OCD Affect Sleep? Win the battle for better sleep

Many findings have shown that those with OCD also suffer from sleep disturbances.

OCD is a terribly exhausting mental health condition. Sufferers can find themselves trapped in a spiral of painful obsessions and intrusive thoughts and lose hours of their day performing compulsive behaviors in the hope of finding a moment’s peace.

But it doesn’t end there.

Beyond having to manage those obsessions and compulsions day in and day out, they also have to manage heavy feelings of uncertainty, guilt, shame, and unworthiness.

It can feel like a 12-hour work shift where you’ve been tasked with carrying a ten-ton weight on your shoulders that you can’t put down.

At the end of the day, a warm welcome bed and a good night’s sleep are not only wanted but needed.

Unfortunately, these nighttime hours of rest are robbed for many OCD sufferers who feel like they can’t turn off their brains or quieten their racing thoughts.

OCD most certainly affects sleep.

And if you find yourself wrestling for some shut-eye among the noise of obsessions and urges of those compulsions, let’s look at how you can win the battle for better sleep.

What effect does OCD have on sleep?

Studies have shown that up to 48% of those with OCD suffer from unhealthy sleeping patterns.

Sleep is an essential part of our day, where our brains get to rest and recuperate. Those sweet slumbers improve brain function and maintain cognitive and emotional processes.

You’ve likely heard many experts talk about the importance of sleep and maintaining a healthy, undisrupted circadian rhythm precisely so our brain and body have time to repair. Think of it as plugging yourself in to charge, like a phone; it’s your ‘top up’ time.

When we aren’t able to recharge – due to lack of sleep – we wake up tired, irritable, and less tolerant.

In the case of those with OCD, they become less tolerant of those obsessions and, therefore, can be more likely to engage in physical and mental compulsions.

It takes a great deal of mental energy to successfully engage in the practices that help us navigate our OCD symptoms, so sleep is essential.

But it becomes this tricky catch-22.

Obsessions and compulsions make it difficult to sleep, and the lack of sleep then makes it harder to manage OCD compulsions.

Can OCD stop you from sleeping?

The truth is, it is in the moments of peace and quiet, just before bed, when the world is winding down and the external sounds drift into silence, that our intrusive thoughts can seem loudest.

In classic OCD fashion, when are those moments of anxiety and doubt most likely to appear? When we are ‘supposed’ to be at our most tranquil.

Indeed, many report that it is in the moments of silence that their obsessions appear to run rampant.

‘What if’ thoughts continue to whirr in their mind, and in the early hours of the morning, they may find themselves trapped in a rumination cycle. Their thoughts seem to be constantly ON. Buzzing away without a moment of relief.

Can OCD stop you from sleeping? Well, it can certainly feel like a hefty hurdle to jump in order to drift off into a restful slumber.

However, there is no hard and fast rule to say that your obsessions will definitely be worse at night. You might be surprised to know that there are plenty of people with OCD who manage to maintain healthy sleeping patterns.

Rest assured, there are ways in which we can help you get a good night’s sleep, even with OCD!

Could it be Insomnia?

OCD and insomnia are two comorbid conditions that frequently go hand in hand.

Those with obsessive-compulsive disorder typically have higher-than-usual rates of insomnia. Insomnia can range in severity from struggling to get to sleep, struggling to stay asleep, struggling to sleep in until your alarm, to only being able to nab a couple of hours here and there.

These irregular sleeping patterns can throw off our body’s natural circadian rhythms that regulate various bodily functions such as sleep-wake cycles, hormone release, body temperature, and metabolism.

As you can imagine, OCD and insomnia combined can feel like genuine torture.

After a long day grappling with the anxiety of those obsessions, the relentless repetitiveness of those compulsions, and the many doubts it leaves you with – Am I going crazy? Am I a bad person?! – it is excruciating then to feel unable to switch off at nighttime when we simply want to REST.

Does OCD get worse with lack of sleep?

Just as stress exacerbates the symptoms of OCD, lack of sleep impacts our ability to manage our obsessions and compulsions during waking hours.

As mentioned above, it takes mental and emotional effort to engage in the best therapeutic practices for OCD recovery. This includes Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP).

These methodologies encourage us to practice sitting with the anxiety and uncertainty brought on by our obsessions, and resist the urge to engage in compulsive behaviors.

The goal is to practice tolerating the anxiety so we can learn that we are capable of managing the uncertainty without the use of safety behaviors.

When we’re exhausted from lack of sleep, it feels harder to do these things.

After a restless night’s sleep, we have less energy to give. Obsessions can appear more intense and more frequent. Compulsions can feel more urgent.

The nature of sleep and OCD is cyclical, so one affects the other.

Thankfully, that also means that if we improve one, we can help improve the other. OCD can be managed, and great sleep can be had!

NOTE: Those who struggle with comorbid conditions such as depression have been shown to have an increase in regular sleep disturbances. The presence of other mental health conditions can also impact our ability to have a good night’s sleep.

How to stop intrusive thoughts at night?

This is a common question (and also a trick question!).

It does not matter whether those obsessions arise during the daytime or nighttime, the goal is never to ‘stop’ intrusive thoughts.

Each time we battle with them, fight them, resist them, or try to suppress them, we only make them stronger and more sticky. 

This can be more difficult to grasp when it comes to nighttime intrusive thoughts because, understandably, we just want them to go away so we can get some shut-eye!

However, the goal is always to change our relationship to those thoughts.

We can learn to give them less weight and validity. When we do this, we can take away the power of these intrusive thoughts and change the meaning we place upon them. Our goal is to carry on with our day, regardless of what thoughts show up and how frequently, and even get a good night’s sleep.

How to help yourself sleep better with OCD

We would always encourage you to get support from a qualified mental health professional first and foremost. Equipping yourself with the knowledge, tools, and support to effectively manage those OCD symptoms is the best way to improve your sleep when you have OCD.

In the meantime, here are some best practices you can implement immediately to help you on your way to a better night’s sleep…

Define a consistent bedtime routine

Also known as ‘sleep hygiene,’ a regular nighttime routine can be a real lifesaver. By opting for a regular set of actions and behaviors before bedtime, you teach your brain that you’re winding down for the day. For example, try to go to bed and wake up at the same time every day (even if you’ve had a bad night’s sleep). When we sleep in after a disturbed night’s sleep, it will impact how well we sleep the following night.

Turn screens off two hours before bed.

The bright lights of our screens, addictive apps, and endless information on our phones and TVs are not conducive to a quiet mind. I’m sure you’ve heard this piece of advice before but it stands true, try to switch off all screens at least two hours before bed so you can begin to ‘slow down’ instead of ‘gearing up’ with every new flashing light!

Practice Mindfulness

Those final hours before bed are a great time to engage in a mindfulness practice. This helps to ground yourself and create a sense of distance between you and your thoughts. A simple practice may be to lie on your bed with your eyes shut and simply listen to your breath as you inhale deeply and exhale fully. Another practice as you wind down for bedtime be mindful in your activities by focusing on the sensations around you such as the smell of the toothpaste, the feel of the toothbrush, the feel of the duvet on your body, etc.

Read non-fiction

Read a book of your choosing that brings you joy! Perhaps you have the autobiography of your favorite comedian, a Bridget Jones-style romcom, or even a light-hearted sci-fi like Hitchhikers Guide to the Galaxy. An uplifting book is a great way to alleviate stress and go to bed on a positive note.

Prioritise slowing down.

Forget about rushing around to fill every waking moment before crashing into bed, make some time to slow down and unwind. A nice evening walk with your partner, a herbal tea in the garden, reading a book by the fire, or even simply sitting on your sofa, allowing yourself to feel whatever you may feel.

Don’t fixate on needing to sleep.

Possibly the toughest nut to crack.

The difficulty many with sleep disturbances have is that, at first, it may be their anxiety that has interrupted their ability to sleep, but eventually, it can be their fixation on wanting to sleep that interrupts the process.

If you’ve ever struggled with sleep and eventually find yourself saying to yourself:

Why can’t I sleep?

I just want to go to sleep!

I’m going to be exhausted tomorrow if I don’t get to sleep!

Then this is for you! The trick here is to be okay with not sleeping if you can’t sleep. Think to yourself, “If I happen to get some sleep, great! If I don’t, that’s okay. I can still function”.

Cognitive Behavioral Therapy for Insomnia (CBT-I)

If you feel as though your sleep disturbances are persistent and severe, you may have co-occurring insomnia alongside your OCD.

CBT-I is the gold-standard treatment to help those who suffer from these comorbid conditions. As described by the Sleep Foundation, “CBT-I focuses on exploring the connection between the way we think, the things we do, and how we sleep. During treatment, a trained CBT-I provider helps to identify thoughts, feelings, and behaviors that are contributing to the symptoms of insomnia.”

Considered effective for both short-term and chronic insomnia, CBT-I techniques involve stimulus control, sleep restriction, and relaxation training to improve the quality of their sleep.

Rest assured, both conditions can be treated and greatly improved using different types of CBT.

How can you get a better night’s sleep with OCD?

Ultimately, we would always suggest that you speak with a qualified OCD clinician.

As mentioned previously, by improving your OCD you will also improve the quality of your sleep. By improving the quality of your sleep, you will also improve your OCD!

One affects the other.

If you’d like tailored OCD support, our team of highly qualified OCD specialists would be delighted to support you in your OCD recovery.

Based in California, we offer a compassionate and non-judgmental approach to OCD treatment. Together with one of our team, you will be supported in using science-backed methodologies that have proven to be highly effective OCD treatments.

We can also look at how to help you find peace at nighttime and improve your sleep.

If you would like support with this, please submit an initial intake form here to speak to one of our friendly therapists.