Role of sleep deprivation in the causation of postpartum obsessive-compulsive disorder.

First-onset or recurrence of obsessive-compulsive disorder (OCD) is common after childbirth. Postpartum OCD can occur alone or in combination with other psychiatric disorders such as mood and anxiety disorders. Putative etiological mechanisms involve consideration of genetic factors, alterations in the serotonin system secondary to changes in levels of gonadal hormones, rise in oxytocin, hypothalamic-pituitaryadrenal axis hyperactivity, and neuroinflammation. Sleep deprivation arising from a host of diverse factors is common after delivery in women with postpartum OCD. The author suggests that sleep deprivation may play a critical role in the etiology of postpartum OCD. Clinical and research implications of this hypothesis are discussed.