(PS13-D85) The Association Between Sleep and Distress Intolerance Within the Obsessive-compulsive Spectrum

Distress intolerance (DI), the perceived inability to withstand negative emotional and physical states, is a cognitive risk factor that has been linked with a variety of psychopathologies, including obsessive-compulsive (OC) spectrum disorders. DI is associated with poor emotion regulation; however, there is a lack of research on what factors may contribute to greater DI. One potential candidate is sleep. Sleep is a process central to human functioning that is thought to play a critical role in maintaining healthy emotion regulation, with sleep difficulties associated with deficits in regulating distress. Despite this, limited research has examined the association between poor sleep and cognitive risk factors associated with emotion regulation, including DI. The current study explored whether poor sleep is related to DI within an OC spectrum sample, using both perceived and behavioral sleep measures. We hypothesized that worse perceived and behavioral sleep would be associated with greater DI. Participants (N = 108) included individuals with clinical OC spectrum disorders (n = 65), including obsessive compulsive disorder and hoarding disorder, as well as healthy controls (n = 43). For the current study, we collapsed the sample given the dimensional distribution of DI. Procedures included two lab visits one week apart, as well as daily data collection between the visits. During the daily period, participants wore an actigraph watch which measured behavioral sleep variables, including average sleep efficiency, latency, and sleep disturbances, as well as the variability of these sleep indicators. Participants also completed daily self-report ratings of their perceived sleep quality. At the second visit, participants completed a measure of perceived sleep (Pittsburgh Sleep Quality Index) and a measure of DI (Distress Intolerance Index). We ran a series of Pearson’s r correlations to examine the association between DI and sleep variables. DI was significantly associated with all perceived sleep measures: greater DI was associated with overall worse perceived sleep (r = .42), lower average daily perceived sleep quality (r = -.23), and greater variability in daily perceived sleep quality (r = .22). Higher levels of DI were also associated with worse sleep using behavioral assessments, including lower actigraph-derived sleep efficiency (r = -.21) and greater sleep disturbances (r = .24). There was no significant relationship between DI and sleep latency, and no associations with the variability of any behavioral indicators (all p's > .05). This study was the first to examine the relationship between sleep and DI using both perceived and behavioral measures of sleep. We found a strong link between perceived sleep and DI, replicating prior work. Additionally, we extended previous research by incorporating behavioral sleep measures. Overall, both perceived and behavioral measures of sleep were associated with DI, suggesting that poor sleep may be an important mechanism contributing to DI. Further longitudinal research is needed to determine whether there is a causal link between poor sleep and greater DI. Clinically, sleep may be an important treatment target to consider for reducing DI and thus downstream symptoms of psychopathology.