Sleep, arousal, and circadian rhythms in adults with obsessive–compulsive disorder: A meta-analysis

• Delayed sleep phase disorder prevalence is greater in individuals with OCD.
• Sleep duration is shorter in individuals with OCD.
• Psychotropic medication use does not account for group differences.
• Comorbid depression did not notably reduce effect magnitudes.
• Circadian rhythm systems may be associated with these effects.

Findings of this meta-analysis show that obsessive–compulsive disorder (OCD) is related to disruptions in both the duration and timing of sleep. PsycINFO and Google Scholar database searches identified 12 relevant studies that compared measures of sleep in individuals with OCD to those of either a healthy control group or published norms. Sleep measures included sleep onset latency, sleep duration, awakening after sleep onset, percentage of rapid eye movement (REM) sleep, percentage of slow wave sleep, and prevalence of delayed sleep phase disorder (DSPD). Individual effect sizes were pooled using a random effects model. Sleep duration was found to be shorter, and the prevalence of DSPD higher, in individuals with OCD compared to controls. Further, excluding samples with comorbid depression did not meaningfully reduce the magnitude of these effects (although the results were no longer statistically significant) and medication use by participants is unlikely to have systematically altered sleep timing. Overall, available data suggest that sleep disruption is associated with OCD but further research on both sleep duration and sleep timing in individuals with OCD is needed.