A network examination of symptoms of obsessive-compulsive disorder and sleep disturbances

Sleep disturbances in people with obsessive-compulsive disorder (OCD) may worsen symptoms of the latter. The presence of insomnia or hypersomnia in patients with OCD does not clarify what features of OCD are directly linked to sleep disturbances. To investigate this issue in depth, we conducted network analyses on the relations among aspects of OCD and disturbances in sleep in 773 patients with a primary diagnosis of OCD who were receiving one of three levels of residential and outpatient treatment. Results indicate that insomnia and hypersomnia had very weak correlations with OCD symptoms and had low bridge and strength centrality. This indicates that merely targeting either sleep disturbances or OCD symptoms may not be the most effective approach to treatment of OCD patients with sleep problems. Further, our findings indicate that within OCD, degree of control over obsessions was the most central symptom, and resistance to both obsessions and com-pulsions possessed the highest bridge strength and expected influence.