Creator: Dr. Aditya Gupta
Published: 2017-03-10T00:30:15-04:00

Patient's Query

Hello doctor,

I have been diagnosed with OCD. My OCD comes in the form of intense fear of sleep for the past five years, but it has gotten worse within the past couple of months. I am afraid the moment sleep comes, I fight this feeling until I am exhausted. How can I make peace with falling asleep and not associate it with fear and something to avoid? I am currently taking Gabapentin 600 mg, Seroquel 100 mg, and Clomipramine 25 mg. I have been on SSRI approximately 20 years back, for anxiety and depression. As I am prone to panic attacks, I have done tests to rule out any heart problem, lung problem or any other physical cause.

Answered by Dr. Aditya Gupta

Hello,

Welcome to icliniq.com.

I will start with the pharmacological part. You can discuss with your treating doctor regarding increasing the dose of Clomipramine, not only will it help with sleep but also in decreasing the obsessions. You can also discuss regarding substituting it with Fluvoxamine if not given a trial yet.

Now a few points regarding non-pharmacological methods that can help with OCD (obsessive-compulsive disorder) are as follows.

Practice patterned breathing exercises like Sudarshan Kriya daily.
Practice steps of sleep hygiene like sleeping and waking up at a regular time, avoiding caffeinated drinks at least eight hours before sleep, avoid using tv, mobile, laptop, etc. half an hour before sleep, instead do relaxing activities like taking a hot shower.
After going to bed, do 4-5-8 pattern breathing that is, inhale for four seconds through the nose, hold breath for five seconds and then exhale via mouth for eight seconds. Repeat 4 to 5 such breathing cycles; it will help you relax and sleep.
BMI (body mass index) needs to be taken care.
You can also take CBT (cognitive behavioral therapy) sessions with a psychotherapist.

I know it is easier said than done but try to accept your obsession, but not the fear or anxiety associated with it. Logging down your obsessions sometimes helps relieve the associated anxiety.

For further queries consult a psychiatrist online --> https://www.icliniq.com/ask-a-doctor-online/psychiatrist

Patient's Query

Hello doctor,

Thank you for responding to me. I have tried CBT and ERP. I do realize that the key is to accept my obsession, but not give it emotional weight. It is a tough struggle between the rational part of my mind and the irrational part. I guess I just need to hear that I am fine and not losing my mind. That is what I fear the most. I suppose that I need to understand that my body will claim the sleep that it needs, no matter what my obsessions may be.

Answered by Dr. Aditya Gupta

Hello,

Welcome back to icliniq.com.

I know it is hard to struggle with your obsession, but at the same time, I also know that you can do it.

You are not losing your mind, and it is just that you do not have control over your thoughts.

Persistence is the key here, and if you do follow sleep hygiene steps and pattern breathing exercises religiously, you will surely get a good sleep.