Effect of concentrated exposure and response prevention on symptoms of insomnia

Abstract

Background: Insomnia symptoms are prevalent among patients with obsessive-compulsive disorder (OCD). This study involved secondary analyses from a previous randomized controlled trial testing if d-Cycloserine (DCS) augmented the effects of the Bergen 4-day treatment (B4DT) for OCD. In this study, the effects of the B4DT on sleep difficulties in a sample of difficult-to-treat OCD were explored. Methods: The three groups received B4DT with either a placebo, 100 mg, or 250 mg of DCS. Patients (N = 163) had either not responded or relapsed after previous exposure-based treatment for OCD. Results: The results showed a small, but robust treatment effect on insomnia symptoms (d = 0.37), maintained at 3-month follow-up (d = 0.38), and 12-month follow-up (d = 0.23). No significant differences between the groups receiving DCS or placebo were found. Insomnia did not affect OCD-treatment outcome. Discussion: This study showed that OCD treatment is associated with some improvement in insomnia symptoms. Comorbid insomnia and DCS did not moderate treatment outcome. Patients with OCD and comorbid insomnia should be considered for specific insomnia treatment.