Santiago Therese, Simbre Isabel, DelRosso Lourdes M
Department of Psychiatry, Stanford University, Stanford, California, USA.
College of BIological Sciences, University of California, Davis, California, USA.
J Sleep Res. 2025 Aug;34(4):e14446. doi: 10.1111/jsr.14446. Epub 2024 Dec 30.
Patients with obsessive-compulsive disorder are presumed to be at higher risk of sleep disorders due to the potential interference that persistent thoughts and compulsions may exert on sleep. Although there are studies on sleep findings in patients with obsessive-compulsive disorder, there are few systematic reviews on the presence of sleep disorders in patients with obsessive-compulsive disorder for adults and children. Preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed to perform a comprehensive search of PubMed and Web of Science using the MeSH terms "obsessive-compulsive disorder" and "sleep wake disorders". The exclusion criteria included publications not in English, studies performed on non-humans, abstracts, reviews, and meta-analyses. After applying the exclusion criteria, 17 studies qualified for inclusion in this systematic review. Nine studies were written about children and eight on adults. In the adult studies, sleep questionnaires, actigraphy and dim light melatonin onset showed delayed circadian rhythm in those with obsessive-compulsive disorder. Several studies showed an increased prevalence of insomnia in adult patients with obsessive-compulsive disorder. Overall, these studies showed sleep-onset and maintenance insomnia, and poor sleep quality. In the paediatric studies, sleep questionnaires revealed that paediatric patients with obsessive-compulsive disorder have increased sleep-related problems, including poor sleep quality, difficulty initiating and maintaining sleep, nightmares and sleepwalking. Two studies using actigraphy demonstrated a decreased total sleep time, increased wake after sleep onset and increased duration of awakening. Studies also showed an improvement in sleep symptoms with cognitive behavioural therapy. The systematic review has shown increased sleep-related problems and poor sleep quality both in adult and paediatric patients with obsessive-compulsive disorder. All patients with obsessive-compulsive disorder should therefore be screened for sleep-related problems to help in the overall outcome of treatment plans.
由于持续的想法和强迫行为可能对睡眠产生潜在干扰，强迫症患者被认为患睡眠障碍的风险更高。尽管有关于强迫症患者睡眠研究的相关报道，但针对成人和儿童强迫症患者睡眠障碍的系统评价却很少。本研究遵循系统评价和Meta分析的首选报告项目（PRISMA）指南，使用医学主题词“强迫症”和“睡眠-觉醒障碍”对PubMed和Web of Science进行全面检索。排除标准包括非英文出版物、非人类研究、摘要、综述和Meta分析。应用排除标准后，有17项研究符合纳入本系统评价的条件。其中9项研究针对儿童，8项针对成人。在成人研究中，睡眠问卷、活动记录仪和暗光褪黑素起始时间显示强迫症患者的昼夜节律延迟。多项研究表明，成年强迫症患者失眠的患病率增加。总体而言，这些研究显示出入睡和维持性失眠以及睡眠质量差。在儿科研究中，睡眠问卷显示患有强迫症的儿科患者与睡眠相关问题增加，包括睡眠质量差、入睡和维持睡眠困难、噩梦和梦游。两项使用活动记录仪的研究表明，总睡眠时间减少、睡眠后觉醒增加以及觉醒持续时间增加。研究还表明，认知行为疗法可改善睡眠症状。该系统评价表明，成年和儿科强迫症患者与睡眠相关的问题均增加，睡眠质量差。因此，所有强迫症患者都应接受与睡眠相关问题的筛查，以有助于治疗计划的整体效果。
