Difficulties with Sleep
Insomnia affects everyone on occasion, caused by worries or physical ailments that delay or interrupt sleep. For the child with OCD, dogged by obsessive worries and fears, occasional sleeplessness can turn into a constant, chronic problem. Sleep problems are also associated with other mental health disorders, especially ADHD, depression, schizophrenia, and bipolar disorder. Sometimes, medications can affect your child's ability to fall and remain asleep. The sleep problems of a child with OCD can undermine a parent's ability to function, making this an area that requires special attention. In other words, don't be a stoic. Do get help; your whole family's health and safety are at risk when you don't get enough sleep as a result of your child's insomnia. Here are some examples from parents of children with OCD:
Stephanie, who is eleven years old, is a very light sleeper who wakes up several times a night. I am in the same boat, since I also have OCD and insomnia.
Jason, who's eight, wakes up in panic attacks. Right now his OCD is making him terrified of rainstorms or a tornado coming and wrecking our house, and killing us all. Any sort of noise, or no noise at all, can set him off. He'll start screaming and have trouble breathing.
Whenever I walk by my twelve-year-old daughter's room at night and peek in, she's awake. She's stopped even calling out to me now, but during the day she has dark circles under her eyes and I feel so bad for her.
Dr. James Claiborn, Ph.D., an OCD treatment specialist in South Portland, Maine, addressed OCD-related sleep problems in his article, “To Sleep, Perchance to Dream,” on the Organized Chaos Web site, Volume 9. Claiborn is also the author (with Cherry Pedrick) of The Habit Change Workbook. He offers the following remedies for insomnia and nighttime panic.
Strange as it may sound, nightmares may also be thought of as a habit problem. The most effective treatment for nightmares is to develop a script for the dream with a different ending. You can choose to make it come out any way you like. You can include things that are impossible in life because the world of dreams allows for magic. When you have a new script, you can rehearse it before bed each night. Despite the fact that nightmares are associated with anxiety disorders, they can be changed without having to do an exposure to the upsetting images.
The mother of Stephanie employed Dr. Claiborn's technique with positive results.
We worked up a box; we actually decorated a shoe-box and called it her “happy endings box.” We took the ideas she'd written out and put them in the box next to her bed. Like she'd go (from a scary place in her dream) to the campground where we spent our last vacation, which she enjoyed. It also worked to use scenes from her favorite movies, to replace the bad scenes that would come to her in nightmares. I had my doubts about this when we started but it's definitely helping her sleep better.
Other ideas offered for helping kids and adults with OCD to get to sleep include:
Make bedtime a comfortable routine; just don't make it into an inflexible ritual.
Go to bed and get up at the same times every day.
Exercise regularly; don't watch TV or use the computer too close to bedtime.
Don't do things in bed other than sleep, like eating, watching TV, or using the computer.
Don't obsess about not sleeping; deal with your fear of being up all night as you would other OCD-related fears: do an ERP exposure on what you fear most might happen.
If insomnia persists and these techniques are ineffective, you should raise the issue with your child's therapist or treating psychiatrist. In some cases, medication changes or additions can help.
