All The Ways OCD Can Affect Your Dreams

When you wake up in the morning, the content of your dreams probably dissipates before you remember all of the details—if you remember them at all. Sometimes, however, the events from your dreams, particularly disturbing ones, rattle you when you wake and stay with you throughout the day. 

If you have obsessive-compulsive disorder (OCD), you may notice that scary or anxiety-inducing dreams are on your mind for long periods of time. That’s because OCD can affect your dreams; it’s one of several sleep issues that accompany OCD. 

Read on to learn more about all the ways OCD and dreams interact, including how dreams might trigger OCD symptoms, what counts as an intrusive dream, and how to get help if dreams are impacting how you feel throughout the day.

Can OCD affect your dreams?

Yes. If you have OCD, you may go to bed while still fixated on obsessions that are making you anxious, worried and stressed during the day, says Dr. Patrick McGrath, psychologist and Chief Clinical Officer at NOCD. Once asleep, you may be disturbed by bad dreams, and these may leave you feeling uneasy or wake you up—making it hard to go back to sleep, or leaving you ruminating.

“Maybe you dream of an intimate moment with someone other than your partner, and then you obsessively worry about what that means,” says NOCD therapist Tracie Ibrahim, LMFT, CST. “When people with OCD wake up and start to wonder if their dream means something about them or suggests a real action they might take, that’s what causes the distress,” says Ibrahim. “Someone without OCD would probably move on a little bit quicker from such a dream.” 

Sometimes, people with OCD even develop an intense fear of dreaming. The worry about dreaming itself can cause significant distress.

Remember, dreams are outside of your conscious control. As such, they may cause heightened distress because you don’t have the ability to perform a compulsion to neutralize the obsession that was triggered in your dreams in order to try to get rid of  your anxiety. For example, if you have fears related to dirt or germs, you may dream about shaking someone’s hand and then—because you’re asleep—you’re not able to run to the nearest bottle of hand sanitizer to escape the distress.

Why do OCD dreams happen in the first place?

While the exact purpose and pathway of dreams is not clear, the most prominent theory is that our dreams are a way for our brains to process and consolidate information from our daily experiences. Scientists know that everybody dreams, and the majority of our dreams take place when we are in REM sleep, a sleep stage that makes up around 25% of a good night’s rest.

“Aspects of what we do in our day-to-day lives often show up in our dreams,” says NOCD therapist Lisa de Guzman, LCSW, PPSC. “It stands to reason that if someone is spending so much of their waking life trapped in the OCD cycle, echoes of their obsessions, anxieties, and compulsions will show up when they’re asleep.” 

Some medications used to treat OCD can also impact sleep and dreaming, either by making dreams less frequent or more vivid, Ibrahim says. For example, prescription drugs and sleep aids—like SSRIs—are prone to causing nightmares.

Intrusive dreams

“Intrusive dream” isn’t an official clinical term, but it’s used to describe the experience of an unwanted, vivid and often disturbing dream content that occurs during sleep and intrudes upon one’s thoughts and emotions even after waking up. 

The disruption caused by these dreams can lead to heightened stress, irritability, insomnia, and difficulty regulating emotions. Intrusive dreams can also trigger compulsions—actions done to try to escape the distress caused by the thought or obsession (or, in this case, the dream).

How OCD obsessions can extend to your dreams  

Obsessions about dreams show up in a variety of forms, usually based on the kinds of fears or subtypes that already exist for someone with OCD. Here are a few examples:

• Harm OCD: If you have harm OCD, you likely feel great fear that you could harm the people around you by acting on your obsessions. Dreams about harming other people may make these fears feel increasingly valid. 
• Sexuality OCD: This OCD subtype is characterized by obsessions about one’s own sexual orientation. Dreams may involve scenarios where you participate in sexual acts not aligned with the orientation you identify with.
• Religious OCD: Religious OCD centers around obsessions about violating religious, moral or ethical beliefs. That can manifest in dreams as telling lies, cursing God, drinking alcohol, or committing a sin. As a result, people with religious OCD may feel the need to seek reassurance or spiritual counsel following one of these dreams.

How dreams can lead to new obsessions in OCD

While your OCD obsessions can impact your dreams, your dreams can also lead to new obsessive thoughts. Here are some examples:

• What if my dreams actually materialize?
• What if my dreams are telling me I need to take a certain action in my life?
• What if my obsessions manifest in my dreams?
• What if I never stop having these bad dreams?
• What if I get stuck in a dream?
• What if I can never wake up from a dream?
• What if I die in my dreams?
• What do my dreams say about who I am? 

Compulsions related to the fear of dreaming

In addition to compulsions that relate to your specific intrusive thoughts and dreams, you might develop compulsions in response to the fear of dreaming. Here are some examples:

• Delaying sleep (avoidance)
• Researching the scientific basis of dreams
• Rumination about what previous dreams mean and/or how they may relate to reality
• Mental review about dreams, or tracking dream content 
• Reassurance seeking from psychics or others thought to have knowledge about dreams
• Confession about an action or decision made in a dream 

Do intrusive dreams mean anything? 

Many people with OCD assign meaning to their intrusive thoughts, intrusive urges, and yes, to their intrusive dreams—which in turn, makes them doubt who they are as a person. It’s crucial to remind yourself that your dreams are not a reflection of your character. They aren’t a window into your soul or to who you really are. “Dreams are just dreams, you don’t have to read into them,” adds Ibrahim.

If you struggle to accept this fact, seeking help from a mental health professional may give you the tools you need to let the contents of your dreams go.

How to get help for OCD symptoms

Treating OCD symptoms in your waking life is key to addressing the intrusive thoughts and obsessions that might also be showing up in your dreams. 

Like intrusive thoughts that come up during the day, dreams often come out of nowhere and can’t be controlled. What can be managed, however, is how you respond to those thoughts or dreams. 

That’s where Exposure and Response Prevention Therapy (ERP) comes in. ERP is considered the gold-standard treatment for OCD, and it’s an evidence-based therapy—which in simple terms means that extensive research has been done to prove that it’s successful. This specialized treatment is unlike traditional talk therapy or general cognitive behavioral therapy (CBT). And without practicing ERP specifically, it’s very likely that your OCD and related intrusive dreams will get worse, not better.

People that haven’t received ERP treatment for OCD may “wake up from a triggering dream and not know how to cope with it, and then start to spiral,” Ibrahim says. After a triggering dream, Ibrahim suggests first grounding yourself in your bedroom and reminding yourself that the dream scenario isn’t real. Then, she says, “get up and start your routine, don’t lay there, don’t try and think about it. Don’t start pondering the dream.” Moving on with your day tells your brain you refuse to validate any obsessive threats and helps you from getting pulled into compulsions.

Sleep hygiene is also helpful for encouraging more peaceful sleep. Creating a relaxing bedtime routine and comfortable sleep environment, as well as managing stress through practices like meditation, exercise, or journaling can help calm the mind and reduce intrusive thoughts during sleep. 

It may also help to avoid stimulating substances like caffeine, nicotine, and alcohol close to bedtime to minimize disruptions to sleep patterns. Additionally, limiting exposure to stimulating or distressing content, such as violent movies or news, before bed may help to prevent particularly distressing dreams.

The takeaway 

“Dreams are just our brains being active while we’re asleep,” Ibrahim says. “There’s nothing you can actively do to control your brain while you’re asleep. The most important thing is taking care of your sleep hygiene and OCD symptoms during the day.”