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In the Spanish thriller Sleep Tight (2011) [original title: Mientras duermes], why is César obsessed with Clara? Does he have a past relation with her?

Additionally, César occasionally goes to hospital to see his sick mom, and tells her about the bad things he's done. Why does he need to tell these to his mom?

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No past with Clara. He is obsessed with her. He is trying to find happiness. He is sick in the head. He tells his mom because he knows she cannot speak therefore cannot tell anyone. I'm pretty sure he might have had something to do with her ending up in the hospital. She knows how he is which is why she cries while listening to césar.

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