Six months ago I started my first job. When I was studying, I usually slept from around 2 am, but now my job demands that I sleep earlier. So I tried going to sleep earlier – at 12 midnight. However, my sleep quality has degraded greatly, and I’ve developed chronic insomnia. Help!

Good sleep hygiene consists of some basic steps, which might or might not sound familiar to you. Good habits include establishing a bedtime routine; relaxing before bed; avoiding caffeine, alcohol, and smoking for a few hours prior to bedtime; refraining from getting into bed until you are sleepy; and getting up after 20 minutes if you are unable to fall asleep. The idea behind getting up is to avoid the experience of lying in bed feeling frustrated or worried for hours, as this can begin to create a negative association with your bed, which leads to even more difficulty falling asleep.

I have thoughts and sometimes images of killing people I know, and thoughts that I’ve hurt a child, although I have no intention of doing anything like that. So I will check them over and over again. I always find myself checking things over and over for fear something bad will happen, and I like things in their place and in a certain order until it feels right. What is wrong with me?

I imagine that your thoughts of killing or harming someone are extremely upsetting because it sounds as though harming someone, especially a child, is the last thing you would want to do. If you would like to seek professional help, it would probably be best to find a therapist who specialises in treating OCD. A particular type of cognitive behavioural therapy that a specialist would likely provide is called exposure and response prevention (ERP). With this treatment, you would learn to cope with the anxiety triggered by the thoughts that you have harmed someone (exposure) without engaging in the checking compulsion (response prevention). This will take some practice and persistence on your part, but it may help to know that many have successfully learned to manage their symptoms of OCD.