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Background <p>Hypervigilance and cortical excitability, which interfere with sleep, are known to contribute to obsessive-compulsive disorder (OCD) and Chronic Insomnia Disorder (CID). A clear picture of how CID patients with comorbid OCD have further disruptions in sleep bioparameters than CID patients without OCD is yet to be portrayed.</p> Objectives <p>This study employed overnight polysomnography (PSG) to collect objective data, aiming to investigate the differences in sleep parameters in CID patients with or without comorbid OCD.</p> Methods <p>We recruited 49 cases of CID (mean age: 28 ± 3.2&#xa0;years) who also underwent PSG to get objectively assessed for sleep architecture and excluded for other sleep disorders. Based on their status for comorbid OCD, which was verified by the Yale-Brown Obsessive-Compulsive Scale and DSM-5 criteria, participants were split into two groups. PSG metrics were comparatively analyzed between groups with particular attention to arousal index, waking after sleep onset (WASO), sleep efficiency, delta progression (DP°), and duration to reach the first sleep stage (SLN1).</p> Results <p>Compared to patients with CID alone (66.2%), individuals with OCD plus CID had lower sleep efficiency (63.5%). Additionally, a substantially raised arousal index (<i>p</i> &lt; 0.05) and disturbed delta progression (<i>p</i> &lt; 0.05) suggested that they were more arousal-leveled. As per the regression analysis, SLN1 (<i>p</i> = 0.01) and WASO (<i>p</i> = 0.015) were important indicators of sleep quality, whereas OCD severity was not found to be a strong predictor.</p> Conclusions <p>CID with comorbid OCD exacerbates sleep disruptions by increasing waking frequency and decreasing sleep efficiency. Our findings imply that treatments aimed at lowering arousal and enhancing sleep arousal stability may be especially helpful for this subset of CID patients. This study lays the groundwork for customized therapies to improve sleep quality in this population by highlighting the value of employing thorough sleep investigations to comprehend how OCD affects sleep in CID patients.</p>

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Comparative Analysis of Sleep Bioparameters in Chronic Insomnia Disorder With and Without Obsessive-Compulsive Disorder: A Polysomnography-Informed Report

  • 期刊论文

  • 发表日期：

    2025年10月5日

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  • Tannaz Baghaei Behzadi,
  • Mansoor Ahmed,
  • Mohammad Nami

摘要

Background

Hypervigilance and cortical excitability, which interfere with sleep, are known to contribute to obsessive-compulsive disorder (OCD) and Chronic Insomnia Disorder (CID). A clear picture of how CID patients with comorbid OCD have further disruptions in sleep bioparameters than CID patients without OCD is yet to be portrayed.

Objectives

This study employed overnight polysomnography (PSG) to collect objective data, aiming to investigate the differences in sleep parameters in CID patients with or without comorbid OCD.

Methods

We recruited 49 cases of CID (mean age: 28 ± 3.2 years) who also underwent PSG to get objectively assessed for sleep architecture and excluded for other sleep disorders. Based on their status for comorbid OCD, which was verified by the Yale-Brown Obsessive-Compulsive Scale and DSM-5 criteria, participants were split into two groups. PSG metrics were comparatively analyzed between groups with particular attention to arousal index, waking after sleep onset (WASO), sleep efficiency, delta progression (DP°), and duration to reach the first sleep stage (SLN1).

Results

Compared to patients with CID alone (66.2%), individuals with OCD plus CID had lower sleep efficiency (63.5%). Additionally, a substantially raised arousal index (p < 0.05) and disturbed delta progression (p < 0.05) suggested that they were more arousal-leveled. As per the regression analysis, SLN1 (p = 0.01) and WASO (p = 0.015) were important indicators of sleep quality, whereas OCD severity was not found to be a strong predictor.

Conclusions

CID with comorbid OCD exacerbates sleep disruptions by increasing waking frequency and decreasing sleep efficiency. Our findings imply that treatments aimed at lowering arousal and enhancing sleep arousal stability may be especially helpful for this subset of CID patients. This study lays the groundwork for customized therapies to improve sleep quality in this population by highlighting the value of employing thorough sleep investigations to comprehend how OCD affects sleep in CID patients.