OCD and Sleep: How Therapy Can Help You Rest Easier

Oct 23

When Sleep Becomes Part of OCD

Many people with Obsessive-Compulsive Disorder (OCD) experience disrupted sleep. Obsessions such as “What if I never fall asleep?” or “What if I’m too tired to function tomorrow?” can trigger anxiety that makes rest even harder.

In fact, research shows people with OCD often report:

Shorter sleep duration
Lower sleep efficiency
Reduced sleep quality
Difficulty falling or staying asleep

This creates a cycle: a poor night’s sleep leads to more worry, which fuels further obsessions and compulsions around bedtime.

Common Sleep-Related OCD Patterns

Obsessions may include:

What if I can’t fall asleep?
What if I wake up and can’t get back to sleep?
What if I don’t get enough hours and can’t perform tomorrow?
What if my sleep never improves?

Compulsions may include:

Strict, perfectionistic bedtime routines.
Compulsively tracking sleep with apps or devices.
Trying to “make up” sleep by going to bed early.
Checking the clock repeatedly.
Ruminating during the day about how tired you feel.

While these behaviours are meant to create control, they often make sleep even more stressful.

How ERP Therapy Helps

At Lotus Counselling in Waterdown, we use Exposure and Response Prevention (ERP) — a gold-standard therapy for OCD — to help clients address sleep-related fears.

ERP for sleep may include:

Flexibility with routines: Practicing letting go of rigid “sleep rules.”
Facing uncertainty: Using coping statements like “I may or may not sleep well tonight, and that’s okay.”
Self-compassion: Reframing self-criticism with supportive, kind inner dialogue.
Shifting focus: Moving attention from “how tired I feel” to “what I’m doing,” reducing OCD’s hold.

When to Consider CBT-I

If sleep continues to be a struggle even after ERP, Cognitive Behavioural Therapy for Insomnia (CBT-I) can be an effective evidence-based treatment. This approach helps retrain both the mind and body for healthier sleep patterns.

Bringing It Back to You

If you or a loved one struggles with OCD and sleep, know that help is available. ERP and CBT-I can both be powerful tools in breaking the cycle of nighttime obsessions and daytime exhaustion.

At Lotus Counselling in Waterdown, Ontario, our clinicians specialize in OCD treatment, anxiety management, and sleep-related concerns. We work with clients across the Waterdown, Hamilton, and Burlington areas.

📞 Contact Lotus Counselling today to learn more about therapy options that support better rest and mental wellness.

Reference & Credit

This blog was inspired by the work of Shala Nicely, LPC, who has written extensively on OCD recovery and ERP therapy. To explore her original article, see: ERP Skills for OCD About Sleep (Nicely, 2025).

Lotus Team