Sleep Disturbance in Pediatric Obsessive-Compulsive Disorder

Sleep disturbance frequently presents in children with OCD. This review summarizes the nature of sleep disturbance in children with OCD, in addition to clinical manifestations and correlates, potential mechanisms, and relevant pharmacological and behavioral interventions.

Subjective and objective sleep measures show consensus with respect to deficits in sleep maintenance and reduced sleep duration in children with OCD. Greater OCD severity, psychiatric comorbidity, and serotonergic medications exacerbate sleep problems. Pre-sleep arousal, repetitive negative thinking, circadian rhythms, and inflammation are purported mechanisms underlying links between OCD and sleep disturbance. Preliminary studies suggest the benefit of cognitive-behavioral therapy, melatonin, and agomelatine on sleep disturbance in children with OCD.

Understanding sleep disturbance in pediatric OCD can inform treatment planning, including cognitive-behavioral interventions, and medication effectiveness and tolerability. Controlled studies are needed to investigate mechanisms underlying OCD-sleep associations and establish efficacy of treatments targeting sleep disturbance in pediatric OCD.