Excessive hoarding is a recognized mental disorder that is characterized by the urge to acquire and save objects, while being unable to discard objects that have no apparent value.
Hoarding disorder was included in the Diagnostic and Statistical Manual of Mental Disorders only recently, in 2013. Until then, it had only been formally recognized as a symptom of obsessive-compulsive personality disorder (OCPD).
Since sleep disturbances have been associated with obsessive-compulsive disorder, researchers set out to determine whether there may be a relationship between insomnia and hoarding. Their findings were published in the Journal of Clinical Psychology in July 2015.
Researchers recruited 24 adults with a diagnosis of hoarding as measured by the Structured Interview for Hoarding Disorder. Of those who took part in the study:
- 54.2 percent were diagnosed with anxiety
- 50 percent were diagnosed with a mood disorder
- 25 percent were diagnosed with current PTSD
Almost all of the participants were women (87.5 percent), the average age of participants was 41 years, and 62.5 percent were Caucasian (the remainder were African American).
Measuring hoarding behavior and insomnia severity
Hoarding behavior was measured using the Saving Inventory-Revised questionnaire which assesses hoarding behaviors such as acquiring items, clutter, and difficulty discarding items (higher scores indicate more severe and frequent hoarding behaviors).
Insomnia severity was measured using the Insomnia Severity Index questionnaire (higher scores reflect more severe sleep problems).
Half of the hoarders in the study demonstrated clinically significant insomnia as measured by the Insomnia Severity Index. After analyzing the data, researchers found that insomnia severity was significantly associated with acquiring items and difficulty discarding items.
Is clutter to blame?
I wrote about why messy rooms can harm sleep back in 2015. The excessive clutter associated with hoarding can have a negative effect on the practice of good sleep hygiene. Clutter can lead to items that should not be associated with sleep ending up in the bedroom — and this is not good for sleep. A hoarder, for example, may be more likely to watch TV in the bedroom, prepare and/or eat food in the bedroom, and bring work into the bedroom.
An excessive amount of clutter can also increase stress and even prevent hoarders from accessing furniture such as the bed.
Interestingly, this study found that insomnia severity was not linked to clutter, but the authors suggested that other measures of sleep not assessed by the Insomnia Severity Index may be (such as impaired sleep quality, sleep duration, circadian rhythm disturbances, and nightmares).
Why is hoarding linked to insomnia?
As pointed out by the authors of this study, sleep disturbances are linked to more reward-motivated behaviors, as well asless activity in decision-making regions of the brain. Therefore, the behavior of accumulating and not discarding items may be driven by a disruption in the ability to process reward value and make appropriate decisions.
In other words, a lack of sleep may encourage hoarding since insomniacs are more sensitive to the positive emotions associated with the acquisition of objects. Furthermore, an impaired ability to understand the true value of items contributes to excessive accumulation, while reduced decision-making abilities can make it harder for insomnia sufferers to get rid of their possessions.
Sleep deprivation is associated with memory impairment and hoarders have also been found to doubt their ability to remember information. As a result, hoarders — and insomnia sufferers — may be more likely to save items as an alternative to having to remember something.
How to tackle insomnia and hoarding
Since the symptoms of insomnia are linked to many of the symptoms associated with hoarding, researchers suggested that sleep issues can lead to a vicious cycle of increasingly poor sleep and increasingly significant hoarding behavior.
Although this was only a small study, insomnia symptoms were found to be a significant predictor of increased hoarding severity. Tackling sleep issues using techniques such as cognitive behavioral therapy for insomnia may therefore lead to overall symptom improvement and better treatment outcomes.
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