Have you ever wondered about the irony of being completely exhausted and yet feeling unable to get a full night’s sleep? Whether you have OCD or not, sleep is vital to your health, and you need it to live. Disturbances in sleep are not unusual for individuals who suffer from mental illnesses, so it’s not surprising that if you have OCD, you may have problems sleeping. It is one of the most common complaints that I hear as an OCD specialist.
For people with OCD, there can be many reasons why getting proper rest is a struggle: it may be that you have been ruminating on an intrusive thought all day and all night, thinking “what could that mean?” Maybe you have the urge to get up and check the doors to ensure they are locked. Perhaps you are a new mother and you feel that you need to check on your newborn throughout the night to ensure they are breathing. Or maybe, you can’t stop worrying that you hurt someone at work, so you keep replaying every detail of a conversation.
When I am working with members who have OCD and the subject of sleep comes up, I am usually met with the familiar response that they have difficulty falling asleep or staying asleep, or that they wake up feeling they lack restful sleep. People with OCD often report that at night, they are likely to replay the events that happened during the day. This makes sense—given the hustle and bustle of people’s lives, many people aren’t “alone” with their thoughts during the day. Some may take several naps throughout the day in a feeble attempt to ward off any intrusive thoughts, only to find themselves alert and flooded with those thoughts at nighttime.
If you have OCD and are having trouble sleeping, you’re not alone. I work with more and more people who are not getting enough sleep. Even many who are seemingly getting enough sleep are not getting high-quality rest. So, what can someone who has OCD do to get better sleep? Here are three things to consider:
Take care of your physical health
This one may seem like a no-brainer, and yet it’s easy to overlook how impactful taking care of our bodies can be for our mental health, and how not doing so can contribute to sleep deprivation. Ask yourself, am I drinking enough water? Am I eating enough nutrients? Am I getting exercise?
Taking care of your body is just as important as your mental health, and it can affect your sleep. Together, they can determine whether your overall well-being thrives or declines. Our bodies require the right fuel to run effectively; taking time to plan ahead for meals and prioritizing healthier foods can leave a lasting mark on your health, both physically and mentally.
The “mind-body connection” is important for people suffering from OCD. Living in a constant state of fear and hyper-arousal can be physically and mentally draining. You are constantly fighting a battle with your inner thoughts. This can take a negative toll on your physical well-being as well.
Long-term stress is a contributing factor to disease development, too. People who struggle with mental health issues are more likely to have physical complaints ranging from headaches and nausea to muscle aches and chronic pain, all of which can impact sleep. More research will be needed to unveil all of the ways in which chronic stress and anxiety impact the physical body, but more information is discovered every day.
Exercise is a widely underutilized tool that not only combats physical illness but can significantly reduce the symptoms of mental illness, as well. Something as simple as taking a walk outside can benefit one’s mental state substantially. Sitting in the sun can not only feel good in a physical sense, but it can be extremely beneficial to your mental health, too! The activities you do during the day can help you when it’s time for bed at night.
I also recommend that you see a doctor for regular check-ups. You should discuss with your doctor how you are feeling and bring up your sleeping difficulties, and you may be able to make lifestyle changes if necessary.
Ruminating is an active behavior: it is trying to solve or figure out a perceived problem. It can look like it is a helpful behavior, but for people with OCD, rumination is a mental compulsion done to neutralize or eliminate anxiety and uncertainty. Often, people with OCD find themselves ruminating even more at night, instead of sleeping.
To stop ruminating, you have to make a choice that no matter what intrusive thought, image, or urge you have, you will not engage with it. Think of it as if you were completing a school task and the teacher said “time’s up,” meaning you’re required to put your pencil down. Metaphorically put your brain down, and quit trying to solve whatever the perceived problem is. This may take some practice for many people with OCD because ruminating feels like second nature. You will have to learn over time how to resist engaging with obsessions.
I know what you’re probably thinking: stopping rumination is “easier said than done.” I don’t mean to make it sound simple or easy—it’s part of a difficult process of unlearning unhelpful behaviors. It takes practice, and the more you stop engaging with intrusive thoughts, images, and urges, the less they will come up. And even when they are present, they will cause less discomfort. This can go a long way toward helping you sleep better.
Being intentional with your routines and behaviors can help you improve your sleep in the long run. To be intentional, you can start by honestly identifying changes that you can make in your routine, particularly before bed. Are you spending time close to your bed working or doing homework? You may not be aware of it, but you are training your brain that your bedroom is not for sleeping. This can make it more difficult for your brain to identify the things that normally tell it that it’s bedtime. Is your room dimly lit and conducive to relaxation and sleep? These are other important factors to consider in getting a good night’s rest.
Technology can also play a role in poor sleeping habits. Do you use a tablet, television, or phone running just before bedtime? If you ask almost anyone, they will tell you that they are rarely—if ever—without some form of technology. Even very young children are being taught to use electronics at younger and younger ages. The problem is that these items can be over-stimulating. This makes it hard to turn off stimulation and fully relax at bedtime. Being intentional about shutting off technology may significantly help with sleep.
Are you someone who doesn’t have a consistent bedtime or nighttime routine, and simply waits till whenever you are tired? If so, I would encourage you to be intentional in developing a routine, as this can help signal to your brain that it’s time for bed, resulting in better sleep over time. Some people find taking a warm bath or shower before bed to be relaxing, while others enjoy reading a good book before getting some shut-eye. Perhaps you are someone who likes to listen to soft music, or you find the sounds of nature to be restful. These are all ways for you to tell your brain that it’s time to wind down for the day. As someone with OCD who struggles with chronic sleep issues, I have found rain sounds to be very soothing, so I like to listen to light rain recordings and drink chamomile tea before bed.
Another important intentional act for people with OCD who struggle with sleep is seeking effective treatment for OCD. Finding a therapist who specializes in OCD and is trained in exposure and response prevention (ERP) therapy is not only imperative to help you manage OCD, but it can be an effective way for you to improve your sleep. An OCD specialist can help you develop a personalized treatment plan that will address the unique factors that are contributing to your lack of sleep or restless sleep.
ERP therapy is the gold standard of treatment for OCD and involves specifically targeting the source of your obsessions by directly exposing you to it over time. In many cases, people find that ERP helps their anxiety subside to the point where they no longer experience intense fears related to their thoughts on a regular basis.
The best way to practice ERP and manage intrusive thoughts and other concerns that are contributing to your sleep issues is to work with a therapist trained in ERP. At NOCD, our therapists specialize in OCD and ERP. Your therapist will teach you the skills needed to begin your OCD recovery journey and will support you every step of the way. They will guide you in taking small steps to reach your goals.
Our team of therapists at NOCD is passionate about the treatment of this debilitating disorder and is trained by world-renowned experts. To learn more about working with a NOCD therapist, schedule a free call with our care team.