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Insomnia in obsessive-compulsive disorder: A Swedish population-based cohort study
Laura Sevilla-Cermeño1, Kayoko Isomura2, Henrik Larsson3
1Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden; Departamento de Medicina y Especialidades Médicas, Universidad de Alcalá, Madrid, Spain.
Journal of Affective Disorders
|February 15, 2020
Summary
Individuals with obsessive-compulsive disorder (OCD) have a nearly 7-fold increased risk of insomnia. This association persists even after accounting for shared family factors and comorbid conditions, highlighting the need for insomnia assessment in OCD patients.
Area of Science:
- Psychiatry
- Sleep Medicine
- Epidemiology
Background:
- The link between psychiatric disorders and insomnia is known, but insomnia prevalence in obsessive-compulsive disorder (OCD) remains unquantified.
- This study investigates insomnia in OCD patients compared to the general population and unaffected siblings.
Purpose of the Study:
- To determine the prevalence of insomnia in individuals with obsessive-compulsive disorder (OCD).
- To assess the contribution of psychiatric comorbidities to the association between OCD and insomnia.
Main Methods:
- A population-based cohort study in Sweden (1973-2013) identified 31,856 individuals with OCD from over 13 million people.
- Logistic regression analyses compared insomnia odds in OCD patients versus the general population and siblings.
- Sensitivity analyses excluded individuals with comorbid psychiatric conditions.
Main Results:
- Individuals with OCD showed nearly 7-fold increased odds of insomnia diagnosis or treatment (42.2% vs. 11.0%).
- Shared familial factors and comorbidities did not fully explain the OCD-insomnia link.
- Excluding comorbid depression or anxiety significantly reduced insomnia odds (ORs 4.97 and 4.51, respectively).
Conclusions:
- Insomnia is significantly more prevalent in individuals with OCD.
- Comorbid anxiety and depression partially mediate the relationship between OCD and insomnia.
- Systematic evaluation and management of insomnia are crucial for OCD patients, especially those with comorbid anxiety and depression.
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