Sleep and suicide by Michael Hempseed

Too often we exclusively talk about the link between depression and suicide. While there certainly is a link between depression and suicide there are many other factors that can contribute to suicidal ideation, such as feelings of hopelessness[1], personality disorders[2], trauma[3] and a same day crisis[4], such as a relationship breakup. One factor many of us do not consider as a risk for suicidal thoughts and behaviour is sleep loss. Researchers are now looking at changes in sleeping patterns and the link between this and suicidal ideation. For this research reflection I have reviewed the paper:

“Objectively Assessed Sleep Variability as an Acute Warning Sign of Suicidal Ideation in a Longitudinal Evaluation of Young Adults at High Suicide Risk” by Rebecca A. Bernert, PhD; Melanie A. Hom, MS; Naomi G. Iwata, MSc; and Thomas E. Joiner, PhD in Journal of Clinical Psychiatry. Published online June 28 2017

We can understand how chronic sleep deprivation can make everything in life seem so much worse than it is. The paper cited above looked at changes in sleeping patterns and found that significant changes in sleeping patterns were associated with an increase of suicidal thoughts. For example, if someone goes to sleep at 10pm one night then the following night they sleep at 2am, this is considered a significant change in sleeping patterns, not just sleep disruption. The paper suggests there is a lot that can be done in the field of suicide prevention if we look at helping people getting consistent sleep.

The alert reader will ask, could the increases in suicidal thoughts just be the result of a larger issue; depression. We have known for decades that depression causes significant sleep changes. The researchers controlled for this and still found significant changes in sleep patterns were associated with an increase in suicidal thoughts, regardless of whether the person did or did not have depression. 

Also noteworthy was the finding that insomnia and nightmares were also associated with an increase in suicidal thoughts.

I believe this paper is particularly important as people commonly report getting less and less sleep and changing sleep patterns.

Significantly more research is needed in this field to understand more about the relationship between sleep disturbances and suicide and to see what effective treatments can be found.

If we want to solve New Zealand’s horrendously high suicide rate then we need to examine all the factors that lead to suicide and not just a few.

The paper was based on a dissertation thesis, the full text can be found here, http://diginole.lib.fsu.edu/islandora/object/fsu:175900/datastream/PDF/view

 

[1] Kovacs, M., & Garrison, B. (1985). Hopelessness and eventual suicide: a 10-year prospective study of patients hospitalized with suicidal ideation. American journal of Psychiatry, 1(42), 559-563.

[2] Coccaro, E. F., Siever, L. J., Klar, H. M., Maurer, G., Cochrane, K., Cooper, T. B., ... & Davis, K. L. (1989). Serotonergic studies in patients with affective and personality disorders: correlates with suicidal and impulsive aggressive behavior. Archives of general psychiatry, 46(7), 587-599.

[3] Roy, A., Gorodetsky, E., Yuan, Q., Goldman, D., & Enoch, M. A. (2010). Interaction of FKBP5, a stress-related gene, with childhood trauma increases the risk for attempting suicide. Neuropsychopharmacology, 35(8), 1674.

[4] Sanchez, H. G. (2001). Risk factor model for suicide assessment and intervention. Professional Psychology: Research and Practice, 32(4), 351.

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