Toronto Metropolitan University, Department of Psychology, 350 Victoria St, Toronto, ON M5B 2K3, Canada.
J Anxiety Disord. 2022 Aug;90:102591. doi: 10.1016/j.janxdis.2022.102591. Epub 2022 Jun 8.
There is growing interest in the relationship between obsessive-compulsive disorder (OCD) and sleep problems in youth, including the development of a theoretical model proposing how these disorders maintain each other. The model suggests that OCD symptoms are proposed to interfere with sleep duration (e.g., via increased arousal and delayed bedtime), which compounds OCD symptom severity during the daytime and into the evening, feeding back into the model. Whether the recent influx of research on sleep problems in youth with OCD supports this model is unknown. The primary aim of this systematic review was to characterize sleep problems in youth with OCD and evaluate whether current research supports previous theoretical inferences. Findings across 20 studies revealed a high prevalence of sleep problems among youth with OCD and support a bidirectional relationship. Studies largely did not assess hypothesized relationships proposed by the model; support for the model is therefore preliminary. A secondary aim was to assess the impacts of comorbidity and developmental stage. Findings suggest that in childhood, comorbid anxiety disorders may initially predate sleep problems, but they become mutually maintained over time; the role of comorbid depression appears to increase with age. Limitations, future directions, and clinical implications are discussed.
人们对青少年强迫症（OCD）和睡眠问题之间的关系越来越感兴趣，包括提出一个理论模型，该模型提出了这些障碍如何相互维持。该模型表明，强迫症症状被认为会干扰睡眠时间（例如，通过增加觉醒和延迟就寝时间），这会在白天和晚上加重强迫症症状的严重程度，并反馈到模型中。最近关于 OCD 青少年睡眠问题的研究是否支持该模型尚不清楚。本系统综述的主要目的是描述 OCD 青少年的睡眠问题，并评估当前研究是否支持先前的理论推论。20 项研究的结果表明，OCD 青少年中睡眠问题的高发率，并支持双向关系。研究在很大程度上没有评估该模型提出的假设关系；因此，对该模型的支持是初步的。次要目的是评估合并症和发育阶段的影响。研究结果表明，在儿童期，合并焦虑症可能最初先于睡眠问题，但随着时间的推移，它们会相互维持；合并抑郁症的作用似乎会随着年龄的增长而增加。讨论了局限性、未来方向和临床意义。
