Søvnforstyrrelser hos pasienter med tvangslidelse før og etter eksponeringsterapi

Mange pasienter med obsessiv kompulsiv lidelse (OCD) har udiagnostiserte komorbide søvnproblemer. Det foreligger lite forskning relatert til hvorvidt komorbide søvnproblemer vanskeliggjør behandling av OCD. Videre er det få studier som undersøker hvorvidt søvnproblemene endrer seg som følge av OCD behandling. I denne studien, gjennomført av forskere fra Bergen, inkluderte man 36 pasienter med OCD.

Pasientene gjennomgikk gruppebasert eksponeringsterapi i 4 sammenhengende dager. Symptomer på OCD, depresjon og søvnforstyrrelser ble undersøkt på tre forskjellige tidspunkter (før, etter og ved 6 måneders oppfølging). Før intervensjon rapporterte nesten 70 % av pasientene søvnvansker som indikerte insomni.

​Sleep disturbances in treatment-seeking OCD-patients: Changes after concentrated exposure treatment.

Publisert i Scandinavian Journal of Psychology.

Håkon Nordal, Audun Havnen, Bjarne Hansen, Lars-Göran Öst, Gerd Kvale

Research indicates that patients with Obsessive Compulsive Disorder (OCD) frequently suffer from comorbid sleep difficulties, and that these difficulties often are not clinically recognized and diagnosed. There has been limited research investigating if comorbid sleep difficulties impair treatment outcome for OCD and if the sleep difficulties change following OCD-treatment. Thirty-six patients with obsessive compulsive disorder underwent concentrated exposure treatment delivered in a group over four consecutive days and were assessed with measures of OCD, depressive symptoms and sleep disturbance at three different time points (pre, post and 6 months follow-up). The sample was characterized by a high degree of comorbidity with other psychiatric disorders. At pre-treatment nearly 70% of the patients reported sleep difficulties indicative of primary insomnia. The results showed that patients had large reductions of OCD-symptoms as well as significant improvements in sleep disturbance assessed after treatment, and that these improvements were maintained at follow-up. Sleep disturbance did not impair treatment outcome, on the contrary patients with higher degree of sleep disturbance at pre-treatment had better outcome on OCD-symptoms after treatment. The results indicated that the majority of the OCD sample suffered from sleep disturbances and that these sleep disturbances were significantly reduced following adequate treatment of OCD without specific sleep interventions. However, a proportion of the patients suffered from residual symptoms of insomnia after treatment.