MHM Magazine

Key points: • Patients of all ages with OCD commonly report sleep problems. • Melatonin regulates the sleep- wake cycle and interacts with some of the neurobiological systems implicated in OCD. • Reduced serum melatonin levels and smaller pineal gland volumes are associated with OCD. • Melatonin may enhance therapeutic outcomes in OCD. The lifetime prevalence of obsessive-compulsive disorder (OCD) ranges between 1% and 3% in the general population. It’s considered among the most debilitating conditions, given its chronic course and profound negative impact across multiple domains of life. OCD patients of all ages report sleep problems, which further exacerbate their distress and functional impairment. Sleep is closely regulated by melatonin, a hormone produced by the pineal gland in response to darkness. In several studies, OCD symptoms have consistently been associated with reduced melatonin levels and greater sleep disturbance. Although selective serotonin reuptake inhibitors (SSRIs) and cognitive-behavioral therapy (CBT) are the cornerstones of OCD treatment, many patients experience partial relief only. This stimulated interest in alternative options to enhance outcomes. Melatonin has drawn attention for its potential neuroprotective, anti-inflammatory, and anxiolytic properties, which may complement standard OCD treatments. Studies on its potential clinical relevance in OCD are lacking, however. In this paper, we briefly describe sleep and circadian rhythm issues in OCD, melatonin’s possible role in psychiatry and in OCD in particular, and discuss its potential therapeutic use in OCD. Disturbances of sleep and circadian rhythm in OCD In OCD, common themes include shortened sleep duration, nocturnal awakenings, reduced sleep efficiency and increased REM sleep. Of note is that in OCD, comorbidity is the rule By Christine Lochner 1 , Amanda Lochner 2 1 SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University 2 Centre for Cardio-Metabolic Research in Africa, Division of Medical Physiology, Stellenbosch University cl2@sun.ac.za MELATONIN: A BRIEF REVIEW OF ITS ROLE AND THERAPEUTIC POTENTIAL IN OBSESSIVE- COMPULSIVE DISORDER (OCD) MHM | 2025 | Volume 12 | Issue 4 | Melatonin: A brief review of its role and therapeutic potential in obsessive-compulsive disorder (OCD) MHM Issue 4 | 2025 | MENTAL HEALTH MATTERS | 9 MHM