Insomnia and obsessive-compulsive symptom dimensions: The mediating role of anxiety and depression

Abstract Background Research supports a relationship between insomnia and obsessive-compulsive symptoms (OCS). However, given gaps in the literature, there is a need to further examine this relationship. Specifically, the present study investigated whether there are unique associations between insomnia and specific OCS dimensions (e.g., contamination, symmetry) above and beyond any relationships with anxiety or depression. We also examined potential mediation pathways for understanding the linkages between sleep, anxiety/depression, and OCS dimensions. Methods A large sample of university students (N = 253) completed measures of insomnia, OCS, and depression, anxiety, and stress. Results The main findings indicated that insomnia severity was associated with all OCS dimensions, and most strongly with unacceptable obsessive thoughts. However, anxiety, depression, and stress fully accounted for the relationship between insomnia and OCS. Additionally, anxiety and depression differentially mediated the relationship between insomnia and specific OCS dimensions. Conclusions Overall, our findings suggest that co-occurring symptoms (e.g., anxiety, depression) may be worthwhile targets to examine in future research aimed to extend our understanding of the mechanisms through which chronic sleep deprivation exerts deleterious effects on OCS. Extending findings to clinical populations and treatment contexts may have important implications for our understanding of the links between insomnia and OCS.