Skip to main content
SpringerLink
Log in

Sleep and Quality of Life in Obsessive-Compulsive Disorder

  • Chapter
Sleep and Quality of Life in Clinical Medicine

Summary

Patients suffering from obsessive-compulsive disorder (OCD) scarcely complain primarily of insomnia. However, sleep disturbance is very common in this population as shown by epidemiological and polysomnographic studies. Clinical psychiatrists have to check for sleep disruptions through a careful medical history of the patient. Special attention will be paid to patients with checking of washing rituals who can delay their sleep during endless compulsive activities. To what extent these sleep problems are related to the pathophysiology of OCD or simply a consequence of the obsessive-compulsive symptoms remains to be addressed in future studies. In OCD, despite initial confusing findings, there is no specific alteration of the sleep structure. However, impaired sleep continuity, intrusion of wake during sleep, and reduction of sleep duration are constantly observed. Endocrine functions are also strongly modified during sleep of OCD sufferers. Adrenocorticotrophic hormone (ACTH) and cortisol are significantly elevated whereas sleep onset-related GH secretion is blunted in patients compared with healthy controls. Clinical experience suggests that the improvement of OCD is strongly linked to the decrease of sleep alterations but the specific impact of insomnia on the course of the illness and the quality of life (QOL) of patients has not been investigated precisely. Neurobiology shows that sleep regulation and OCD pathophysiology share common serotoninergic mechanisms, suggesting that their relationship is not fortuitous. Prescription of serotonin-acting antidepressant for OCD has to be reassessed to prevent further alteration of sleep structure. Actually, antidepressants active on OCD stimulate vigilance and could disrupt sleep continuity. From a therapeutic point of view, we need to determine the reciprocal effects of specific treatments (ODC or sleep focused) on the evolution of the other variables. It is likely that sleep care should facilitate OCD treatment and reciprocally.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Insel TR, Gillin JC, Moore A, Mendelson WB, Loewenstein RJ, Murphy DL. The sleep of patients with obsessive-compulsive disorder. Arch Gen Psychiatry 1982;39:1372–1377.

    PubMed  CAS  Google Scholar 

  2. Pigott TA, L’Heureux F, Dubbert B, Bernstein S, Murphy DL. Obsessive compulsive disorder: comorbid conditions. J Clin Psychiatry 1994;55 (Suppl.):15–27.

    PubMed  Google Scholar 

  3. Angst J, Gamma A, Endrass J, Goodwin R, Ajdacic V, Eich D, Rossler W. Obsessive-compulsive severity spectrum in the community: prevalence, co-morbidity, and course. Eur Arch Psychiatry Clin Neurosci 2004;254:156–164.

    PubMed  Google Scholar 

  4. Karno M, Golding JM, Sorenson SM, Burnam A. The epidemiology of obsessive-compulsive disorder in five US communities. Arch Gen Psychiatry 1988;45:1094–1099.

    PubMed  CAS  Google Scholar 

  5. Saxena S, Rauch SL. Functionnal neuroimaging and the neuroanatomy of obsessive-compulsive disorder. Pediatr Clin North Am 2000;23:563–586.

    Article  CAS  Google Scholar 

  6. Kuelz A, Hoagen F, Voderholzer U. Neuropsychological performance in obsessive-compulsive disorder: a critical review. Biol Psychol 2004;65:185–236.

    Article  PubMed  Google Scholar 

  7. Moritz S, Jacobsen D, Willenborg B, Jelinek L; Fricke S. A check on the memory deficit hypothesis of obsessive-compulsive checking. Eur Arch Psychiatry Clin Neurosci 2006;256:82–86.

    Article  PubMed  Google Scholar 

  8. Pigott TA, Seay SM. A review of the efficacy of selective serotonin reuptake inhibitors in obsessive-compulsive disorder. J Clin Psychiatry 1999;60:101–106.

    Article  PubMed  CAS  Google Scholar 

  9. Broocks A, Pigott TA, Hill JL, Canter S, Grady TA, L’Heureux F, Murphy DL. Acute intravenous administration of ondasetron and m-CPP, alone and in combination, in patients with obsessive-compulsive disorder (OCD): Behavioural and biological results. Psychiatry Res 1998;79:11–20.

    Article  PubMed  CAS  Google Scholar 

  10. Benkelfat C, Murphy DL, Zohar J, Hill JL, Grover G, Insel TR. Clomipramine in obsessive-compulsive disorder. Further evidence for a serotoninergic mechanism of action. Arch Gen Psychiatry 1989;46:23–28.

    PubMed  CAS  Google Scholar 

  11. Kang DH, Kwon JS, Kim JJ, Youn T, Park HJ, Kim MS, Lee DS, Lee MC. Brain glucose metabolic changes associated with neuropsychological improvements after 4 months of treatment in patients with obsessive-compulsive disorder. Acta Psychiatr Scand 2003;107:291–297.

    Article  PubMed  Google Scholar 

  12. Stengler-Wenzke K, Muller U, Angermeyer MC, Sabri O, Hesse S. Reduced serotonin transporter-avialablity in obsessive-compulsive disorder (OCD). Eur Arch Psychiatry Clin Neurosci 2004;254:252–255.

    PubMed  Google Scholar 

  13. Swedo SE, Leonard JL, Kruesi MJ, REttew DC, Listwak SJ, Berrettini W, Stipetic M, Hamburger S, Gold PW, Potter WZ. Cerebrospinal fluid neurochemistry in children and adolescents with obsessive-compulsive disorder. Arch Gen Psychiatry 1992;49:29–36.

    PubMed  CAS  Google Scholar 

  14. Barr LC, Goodman WK, McDougle CJ, Delgado PL, Heninger GR, Charney DS, Price LH.Tryptophan depletion in patients with obsessive-compulsive disorder who respond to serotonin reuptake inhibitors. Arch Gen Psychiatry 1994;51:309–317.

    PubMed  CAS  Google Scholar 

  15. Voderholzer U, Riemann D, Huwig-Poppe C, Kuelz AK, Kordon A, Bruestle K, Berger M, Hohagen F. Sleep in obsessive-compulsive disorder: Polysomnographic studies under baseline conditions and after experimentally induced serotonin deficiency. Eur Arch Psychiatry Clin Neurosci 2006;5: publishedonline.

    Google Scholar 

  16. LaSalle VH, Cromer KR, Nelson KN, Kazuba D, Justement L, Murphy DL. Diagnostic interview assessed neuro-psychiatric disorder co-morbidity in 334 individuals with obsessive-compulsive disorder. Depress Anxiety 2004;19:163–173.

    Article  PubMed  Google Scholar 

  17. Nestadt G, Addington A, Samuels J, Liang KY, Bienvenu OJ, Riddle M, Grados M, Hoehn-Saric R, Cullen B. The identification of OCD-related subgroups based on co-morbidity. Biol Psychiatry 2003;53:914–920.

    Article  PubMed  Google Scholar 

  18. Nestadt G, Samuels J, Riddle MA, Liang KY, Bienvenu OJ, Hoehn-Saric R, Grados M, Cullen B. The relationship between obsessive-compulsive disorder and anxiety and affective disorders: results from the John Hopkins OCD family study. Psychol Med 2001;31:481–487.

    Article  PubMed  CAS  Google Scholar 

  19. Moritz S, Meier B, Hand I, Schick M, Jahn H. Dimensional structure of the Hamilton Depression Rating Scale in patients with obsessive-compulsive disorder. Psychiatry Res 2004;125:171–180.

    Article  PubMed  Google Scholar 

  20. Angst J, Gamma A, Endrass J, Hantouche E, Goodwin R, Ajdacic V, Eich D, Rossler W. Obsessive-compulsive syndrome and disorders: significance of co-morbidity with bipolar and anxiety syndromes. Eur Arch Psychiatry Clin Neurosci 2005;255:65–71.

    Article  PubMed  Google Scholar 

  21. Fineberg NA, Fourie H, Gale TM, Sivakumaran T. Comorbid depression in obsessive compulsive disorder (OCD) : Symptomatic differences to major depressive disorder. J Affect Dis 2005;87:327–330.

    Article  PubMed  Google Scholar 

  22. Fineberg NA, Gale TM. Evidence-based pharmacotherapy of obsessive-compulsive disorder. Int J Neuropsychopharmacol 2005;8:107–129.

    Article  PubMed  CAS  Google Scholar 

  23. Baldwin DS, Anderson IM, Nutt, DJ, Bandelow B, Bond A, Davidson JRT, De Boer JA Fineberg NA, Knapp M, Scott J, Wittchen HU. Evidence-based guidelines for the pharmacological treatment of anxiety disorders: Recommendations from the British Association for Psychopharmacology. J Psychoparmacol 2005;19:567–596.

    Article  CAS  Google Scholar 

  24. Kobak KA, Greist JH, Jefferson JW, Katzelnick DJ, Henk HJ. Behavioral versus pharmacological treatments of obsessive compulsive disorder: a meta-analysis. Psychopharmacology (Berl) 1998;136:205–216.

    Article  CAS  Google Scholar 

  25. Uhde TW. Anxiety disorders. In Kryger MH, Roth T, Dement WC (Eds). Principles and Practice of Sleep Medicine(3rd ed.). New York: WB Saunders. 2000:1123–1139.

    Google Scholar 

  26. Robinson D, Walsleben J, Pollack S, Lerner G. Nocturnal polysomnography in obsessive-compulsive disorder. Psychiatry Res 1998;80:257–263.

    Article  PubMed  CAS  Google Scholar 

  27. Rapoport J, Elkins R, Langer DH, Sceery W, Buchsbaum MS, Gillin C, Murphy DL, Zahn TP, Lake R, Ludlow C, Mendelson W. Childhood obsessive-compulsive disorder. Am J Psychiatry 1981;138:1545–1554.

    PubMed  CAS  Google Scholar 

  28. Hohagen F, Lis S, Krieger S, Winkelmann G, Riemann D, Fritsch-Montero R, REy E, Aldenhoff J, Berger M. Eur Arch Psychiatry Clin Neurosci 1994;243:273–278.

    Article  PubMed  CAS  Google Scholar 

  29. Smith MT, Huang MI, Manber R. Cognitive behavior therapy for chronic insomnia occurring within the context of medical and psychiatric disorders. Clin Psychology Rev 2005;25:559–592.

    Article  Google Scholar 

  30. Kupfer DJ, Ehlers CJ, Pollock BJ, Nathan RS, Perel JM. Clomipramine and EEG sleep in depression. Psychiatry Res 1989;30:165–180.

    Article  PubMed  CAS  Google Scholar 

  31. Nicholson AN, Pascoe PA. 5-HT and noradrenaline uptake inhibitor : Studies of sleep in man. Neuropharmacology 1988;25:1079–1083.

    Article  Google Scholar 

  32. Sauteraud A, Menny JC, Philip P, Peyré F, Bonnin JM. Dreams in obsessive-compulsive disorder. An analysis of semantic and emotional content compared to control. J Psychosom Res 2001;51:451–457.

    Article  PubMed  CAS  Google Scholar 

  33. Beck AT, Ward CH. Dreams of depressed patients, characteristic themes in manifest content. Arch Gen Psychiatry 1961;5:462–467.

    PubMed  CAS  Google Scholar 

  34. Free MK, Winget CN, Whitman RM. Separation anxiety in panic disorder. Am J Psychiatry 1993;150:595–599.

    PubMed  CAS  Google Scholar 

  35. Kluge M, Schüssler, Künzel HE, Dresler M, Yassouridis A, Steiger A. Increased nocturnal secretion of ACTH and cortisol in obsessive compulsive disorder. J Psychiatric Res 2006, published online.

    Google Scholar 

  36. Brambilla F, Bellodi L, Perna G, Arancio C, Bertani A. Dopamine function in obsessive-compulsive disorder: growth hormone response to apomorphine stimulation. Biol Psychiatry 1997;42:889–897.

    Article  PubMed  CAS  Google Scholar 

  37. Lucey JV, Butcher G, Clare AW, Dinan TG. Elevated growth hormone responses to pyridostigmine in obsessive-compulsive disorder: evidence of cholinergic supersensitivity. Am J Psychiatry 1993;150:961–962.

    PubMed  CAS  Google Scholar 

  38. Sallee FR, Vrindavanam NS, Deas-Nesmith D, Odom AM, Carson SW, Sethuraman G. Parental clomipramine challenge in depressed adolescents: mood and neuroendocrine response. Biol Psychiatry 1998;44:562–567.

    Article  PubMed  CAS  Google Scholar 

  39. Fineberg NA, Cowen PJ, Kirk JW, Montgomery SA. Neuroendocrine responses to intravenous L-tryptophan in obsessive compulsive disorder. J Affect Disord 1994;32:97–104.

    Article  PubMed  CAS  Google Scholar 

  40. Kluge M, Schüssler P, Weikel J, Dresler M, Zuber V, Querfurt F, Yassouridis A, Steiger A. Altered nocturnal growth hormone (GH) secretion in obsessive compulsive disorder. Psychoneuroendocrinology 2006;31:1098–1104.

    Article  PubMed  CAS  Google Scholar 

  41. Steiger A. Sleep and endocrine regulation. Front Biosci 2003;8:358–376.

    Article  Google Scholar 

  42. Murray CJL, Lopez AD. The global burden of disease. Boston (MA) Harvard University Press; 1996.

    Google Scholar 

  43. Sorensen CB, Kirkeby L, Thomsen PH. Quality of life with OCD. A self-reported survey among members of the Danish OCD Association. Nord J Psychiatry 2004;58:231–236.

    Article  PubMed  Google Scholar 

  44. Masellis M, Rector NA, Richter MA. Quality of life in OCD: Differential impact of obsessions, compulsions, and depression co-morbidity. Can J Psychiatry 2003;48:72–77.

    PubMed  Google Scholar 

  45. Koran LM, Thienemann ML, Davenport R. Quality of life for patients with obsessive-compulsive disorder. Am J Psychiatry 1996;153:783–738.

    PubMed  CAS  Google Scholar 

  46. Eisen JL, Manceboa MA ,Pintoa A, Colesb ME, Paganoa ME, Stouta R, Rasmussen SA. Impact of obsessive-compulsive disorder on quality of life. Compr Psychiatry 2006;47:270–275.

    Article  PubMed  Google Scholar 

  47. Moritz S, Rufer M, Fricke S, Karow A, Morfeld M, Jelinek L, Jacobsen D. Quality of life in obsessive-compulsive disorder before and after treatment. Compr Psychiatry 2005;46:453–459.

    Article  PubMed  Google Scholar 

  48. Stengler-Wenzke K, Kroll M, Matschinger H, Angermeyer MC. Quality of life of relatives of patients with obsessive-compulsive disorder. Compr Psychiatry 2006;47:523–527.

    Article  PubMed  Google Scholar 

  49. Goldenberg F, Hindmarch J, Joyce CRB, Quera-Salva MA. Zopiclone, sleep and health-related quality of life. Hum Psychopharmacol 1994;9:245–252.

    Article  Google Scholar 

  50. Léger D, Quera-Salva MA, Philip P. Health-related quality of life in patients with insomnia treated with zopiclone. Pharmacoeconomics 1996;10(Suppl 1):39–44.

    PubMed  Google Scholar 

  51. Hatoum HT, Kong SX, Kania CM, Wong JM, Mendelson WB. Insomnia, health-related quality of life and healthcare resource consumption: a study of managed-care organisation enrollees. Pharmacoeconomics 1998;14:629–637.

    Article  PubMed  CAS  Google Scholar 

  52. Zammit GK, Weiner J, Damato N, Sillup JP, McMillan CA. Quality of life in people with insomnia. Sleep 1999;22:S379–S385.

    PubMed  Google Scholar 

  53. Ohayon M, Lemoine P. Dyatime consequences of insomnia in the French general population. Encephale 2004;30:222–227.

    Article  PubMed  CAS  Google Scholar 

  54. Taylor DJ, Lichtein KL, Durrence H, Reidel BW, Bush AJ. Epidemiology of insomnia, depression and anxiety. Sleep 2005;28:1457–1464.

    PubMed  Google Scholar 

  55. Craske MG, Barlow DH. Nocturnal panic. J Nerv Ment Dis 1989;177:160–167.

    Article  PubMed  CAS  Google Scholar 

  56. Breslau N, Roth T, Rosenthal L, Andreski P. Sleep disturbance and psychiatric disorders: a longitudinal epidemiological study of young adults. Biol Psychiatry 1996;39:411–418.

    Article  PubMed  CAS  Google Scholar 

  57. Weissman MM, Greenwald S, Niño-Murcia G, Dement WC. The morbidity of insomnia uncomplicated by psychiatric disorders. Gen Hosp Psychiatry 1997;19:245–250.

    Article  PubMed  CAS  Google Scholar 

  58. Johnson EO, Roth T, Breslau N. The association of insomnia with anxiety disorders and depression: Exploration of the direction of risk. J Psychiatric Res 2006;40:700–708.

    Article  Google Scholar 

  59. Roman V, Walstra I, Luiten PGM, Meerlo P. Too little sleep gradually desensitizes the serotonin 1A receptor system. Sleep 2005;28:1505–1510.

    PubMed  Google Scholar 

  60. Hedlund PB, Sutcliffe JG. The 5-HT7 receptor influences stereotypic behavior in a model of obsessive-compulsive disorder. Neurosci Lett 2007; published online.

    Google Scholar 

Download references

Authors
  1. Alain Nicolas
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Section Psychopharmacology Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3508TB, PoBox 80082, Utrecht, The Netherlands

    Joris C. Verster

  2. Divison of Clinical Pharmacology and Experimental Therapeutics Department of Medicine, College of Physicians and Surgeons of Columbia University, 630 West 168th Street - Rm # BB813, New York, NY 10032, USA

    S. R. Pandi-Perumal

  3. Department of Psychiatry, Kunin-Lunenfeld Applied Research Unit (KLARU), 3560 Bathurst St., Toronto, M6A 2E1, Canada

    David L. Streiner

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Humana Press, Totowa, NJ

About this chapter

Cite this chapter

Nicolas, A. (2008). Sleep and Quality of Life in Obsessive-Compulsive Disorder. In: Verster, J.C., Pandi-Perumal, S.R., Streiner, D.L. (eds) Sleep and Quality of Life in Clinical Medicine. Humana Press. https://doi.org/10.1007/978-1-60327-343-5_30

Download citation

  • DOI: https://doi.org/10.1007/978-1-60327-343-5_30

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-60327-340-4

  • Online ISBN: 978-1-60327-343-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation