The worsening of OCD symptoms at night is due to decreased distraction, higher rumination, and anxiety. Medications, psychotherapies, maintaining sleep hygiene for OCD, and stress management techniques help to cope with OCD and linked sleep issues.
If you want to know why OCD gets worse at night and what ways to cope with it, then read this article.
Top Reasons for OCD Worsening at Night & Ways to Deal With It
It’s quite common that obsessive thoughts, which are one of the common OCD symptoms, get worse or increase in intensity at night, and individuals fail to relax or sleep properly at night.
What is OCD?
Obsessive-compulsive disorder (OCD) is a complex mental health condition that comprises unwanted intrusive thoughts (obsessions) and repeated behaviors (compulsions). Both obsessive thoughts and compulsive behavior make it hard for an individual with OCD to perform normal life functions.
Intrusive Thoughts vs. Compulsions
Intrusive thoughts: Intrusive thoughts are the unwanted or undesired thoughts, images, or ideas that appear in OCD individuals without their conscious control.
Compulsions: Compulsions are repetitive behaviors or actions that a person performs to reduce anxiety.
Is Nighttime OCD a Subtype of OCD?
No, nighttime OCD is not recognized or categorized as a subtype of OCD. It is a condition in which OCD symptoms, especially intrusive thoughts, get intensified, particularly at night, and therefore individuals experience some major sleep issues.
Why do OCD Symptoms Get Worse at Night?
Night is the time of sleep when individuals take a break from their hectic daily schedule. But in individuals who are suffering from OCD, their intrusive or obsessive thoughts become intensified at night, and they face difficulty in falling or staying asleep. Everyone is sleeping, but they alone battle with their intrusive thoughts. The occurrence of intrusive thoughts is normal if it occurs at normal levels. However, if the level exceeds, then it could be a sign of any mental illnesses, such as obsessive-compulsive disorder.
In addition, many people with OCD are also diagnosed with the sleeping disorder: insomnia. Several recent studies have reported that approximately 42.2% OCD individuals suffer from insomnia. Other than the diagnosis of insomnia, they also receive psychiatric medications specifically to treat their sleeping issues in OCD. If you are an OCD person, then there is an increased probability that you will also suffer from sleep issues. So if you have major OCD symptoms such as obsessions or compulsions, then it means that you may have to face several difficulties in different areas of your life.
Intrusive thoughts appear in different forms, such as certain images, sounds, feelings, thoughts, or sensations. In some cases, there is a trigger behind each intrusive thought, while in others, there is no apparent trigger.
Read More About: OCD Symptoms Checklist
Reduced Number of Distractions
Intrusive thoughts can appear in the mind at any time of day, but in most individuals, they become more frequent and intense at night due to lower distractions because daytime is filled with several activities that distract the minds of individuals, such as different academic and social activities.
Increased Rumination
As nighttime is devoid of any distractions, people start overthinking. Their mind gets filled with the past distressing events or scenarios. Moreover, they even start solving those puzzles that they always get stuck on. So the period of night is quiet, but it is a chain of never-ending thoughts in the case of OCD.
Major Role of Brain Chemistry & Circadian Rhythms
Behind the OCD worsening at night, there is a direct effect of certain changes in the brain chemistry and the body’s normal sleep-wake cycle (circadian rhythms).
OCD and Altered Brain Chemistry
Various studies have mentioned that in OCD, there is one major alteration in the level of some main neurotransmitters, which include dopamine, serotonin, gamma-aminobutyric acid, and glutamate. Their altered levels directly contribute to the development of OCD symptoms in individuals.
Altered Circadian Rhythms & Sleep Issues
Individuals with OCD also have dysregulation in the normal circadian rhythms. Moreover, melatonin is the major hormone that induces sleep. In OCD individuals, this hormone is released in lesser quantities and therefore affects the sleep quality and duration, and individuals face difficulty in falling or staying asleep at night.
The impact of sleep deprivation on OCD
Sleep deprivation is one of the major factors that can also result in the rise in severity of OCD symptoms in individuals. If you do not get sufficient sleep, then there is an increased probability that you will face difficulty in managing your intrusive thoughts and resulting compulsions.
This creates a positive feedback loop in which sleep deprivation issues can increase the worsening of OCD symptoms, and likewise, the presence of OCD symptoms also affects sleep and can result in major sleep issues such as insomnia or other common sleeping disorders.
Somniphobia
Somniphobia is a condition in which some OCD individuals feel excessive fear of sleep. Before sleeping, they start thinking that they will experience nightmares that will make them afraid. Likewise, they also fear that something bad can happen to them when they sleep.
Which sleep disorders are common in OCD individuals?
Individuals suffering from OCD usually suffer from the following mental health issues:
- Insomnia
- Delayed sleep phase syndrome
- Nightmares
- Sleep fragmentation
- Other sleep issues
Read More About: Can OCD Be Cured?
The OCD-Insomnia-Anxiety Cycle
There is a cycle of OCD, insomnia, and anxiety in which one elevates the other.
- The cycle starts with OCD when different intrusive thoughts appear in the mind of individuals, and then individuals engage in different compulsive behaviors.
- Both intrusive thoughts and compulsive behaviors interfere with normal sleep patterns, and individuals have difficulty falling or staying asleep. When they try to sleep, several racing or intrusive thoughts appear in their mind, which not only disturb their mental peace but also their normal sleep-wake patterns.
- Insomnia or lack of sleep directly affects emotional stability and ultimately causes anxiety. Due to a lack of sleep, the brain faces difficulty in managing the intensity of emotions and the result of stress or anxiety. The higher the anxiety levels, the more severe the OCD symptoms.
What Are the Ways to Cope With OCD at Night?
The following are the main ways that help OCD individuals recover from worsening OCD at night.
Identify The Reasons for Triggers
Individuals should understand first what the main triggers behind their intrusive thoughts or what makes them anxious at night are. After the complete identification, they can find ways to help overcome OCD and sleep issues.
Understanding Each Aspect of OCD
There should also be a complete understanding of each aspect of OCD, intrusive thoughts, and their impact on sleep.
Medications
Medications assist in managing the intensity of OCD symptoms. The following are the major medications that experts prescribe:
- Selective serotonin reuptake inhibitors
- Tricyclic antidepressants
Cognitive Behavioral Therapy For Managing Night-Time OCD
Cognitive behavioral therapy is a type of talk therapy that is focused on helping OCD individuals deal with their intrusive thoughts and associated compulsive behavior. Cognitive behavioral experts first identify what are the main triggers of intrusive thoughts and how they affect the mental state of individuals. After that, they teach the individuals different ways or strategies to deal with them.
Exposure and Response Prevention Therapy
Exposure and response prevention therapy is also considered useful for managing OCD and its related symptoms. In ERP sessions, individuals are asked to gradually expose themselves to the situations, objects, or things that trigger their intrusive thoughts. Instead of an instant response, they are asked to resist performing the compulsive behaviors that are triggered by their intrusive thoughts. With time, they learn to face their fear with courage and confidence.
Mindfulness and Acceptance Techniques
The first thing that each individual should remember is that each individual should accept their thoughts and acknowledge them instead of criticizing them. Then the thing that can work is the regular practice of mindfulness techniques. By doing this, they can get detached from their intrusive thoughts and instead of focusing on the past or future, they stay in the present moment and enjoy every single moment of their life with mindfulness.
Sleep Hygiene for OCD
Sleep hygiene is also vital for having a good quality of sleep and managing OCD symptoms. Before going to sleep, you should ensure the following things:
- A calm environment
- Maintain a consistent sleep schedule.
- Cleaning of the body
- Limiting excessive screen time before bed
If you do this on a daily and regular basis, then you will see a difference in your sleep and mental health.
Relaxation Techniques
Different relaxation techniques can also help OCD individuals to stay relaxed at night, such as:
- Deep breathing
- Yoga
- Meditation
Healthy & Positive Distraction
At night, if you feel that intrusive thoughts are hijacking your mind, then you can distract your mind towards positive things, such as reading a book, listening to a song, etc.
When to Seek Professional Help
The moment when you feel that your OCD symptoms are causing poor quality of sleep on every single day and your intrusive thoughts are directly interfering with your normal life functioning, is the best time when you should immediately seek professional help from experts. Find the best platform where you can find the best professionals who are experts in diagnosing and treating OCD.
Bottom Line
Obsessive-compulsive disorder is a common mental illness that involves obsessions and compulsions. At night, OCD symptoms get worse, which specifically include intrusive thoughts. The mind of individuals gets filled with an increasing number of intrusive or undesired thought, which in turn make it difficult for individuals to stay or fall asleep. Individuals suffering from OCD usually deal with major sleep issues, which include insomnia, delayed sleep phase syndrome, and nightmares, etc. However, the right therapeutic strategies, including medications and psychotherapies, especially cognitive behavioral therapy and exposure and response prevention therapy, work best in overcoming OCD and associated sleep issues.
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If you or someone you know is suffering from OCD and looking for the best professional help, then we can help you. Brainpower Wellness Institute is a top-rated platform where you can find highly effective psychiatric services for each individual, including children, teens, and adults.
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