Nightmares and unhealthy beliefs about sleep may increase the risk of suicide in people who are depressed, a new study suggests.The findings reaffirm earlier research linking sleep problems
to
an increased risk of suicide, and suggest which symptoms doctors might
want to target with treatment to reduce that risk, the researchers said.
Unhealthy
beliefs about sleep can take several forms: for example, the thought
that a poor night's sleep will disturb sleep for the whole week, or that
sleep loss will have dire and irreversible consequences. Such ideas
carry an atmosphere of hopelessness, an emotion researchers know is
connected to suicide risk.
"Insomnia can
lead to a very specific type of hopelessness, and hopelessness by
itself is a powerful predictor of suicide," said study researcher Dr. W.
Vaughn McCall, chair of the Department of Psychiatry and Health
Behavior at Georgia Health Sciences University in Augusta.
can
lead to a very specific type of hopelessness, and hopelessness by
itself is a powerful predictor of suicide," said study researcher Dr. W.
Vaughn McCall, chair of the Department of Psychiatry and Health
Behavior at Georgia Health Sciences University in Augusta.
While
the factors that contribute to suicide risk are not the same for
everyone, "For some patients, I think sleep problems are part of the
[symptom] profile," McCall said.
During
the study, McCall and colleagues surveyed 50 depressed people ages 20
to 84, some of whom were in the hospital. Nearly every patient was
taking some type of psychiatric medication, and 56 percent had attempted
suicide at least once.
The
study participants were surveyed to assess their degree of insomnia and
suicidal thinking, as well as whether they experienced nightmares or
unhealthy beliefs about sleep.
The
study found a link between insomnia and suicidal thinking: The more
severe a person's insomnia was, the more likely he or she was to express
suicidal thoughts and desires. However, when the researches took into
account whether or not individuals experienced frequent nightmares or
unhealthy beliefs about sleep, the link disappeared. This indicates the
two factors —nightmares and unhealthy beliefs about sleep —play a role
in the link.
Earlier
studies have found that people with insomnia are up to twice as likely
to commit suicide as people who don't have such difficulties sleeping. A
2011 study in teens found that those who had sleep problems at ages 12
to 14 were 2.5 times more likely to have suicidal thoughts in their late teen years.
.
Depending
on the person, insomnia could be a cause or an effect of depression,
McCall said. Insomnia may exacerbate depression because people feel they
cannot find relief or escape from their condition, even at night, he
said.
"People become pretty discouraged and demoralized living with insomnia night and after night," McCall said.
The
new study, along with previous work, suggests that people with insomnia
should be evaluated for mental illness, including depression and
suicide risk, McCall said.
Treating
nightmares or unhealthy beliefs about sleep with psychotherapy or,
perhaps, medication may reduce the risk of suicide, but future studies
will be needed to investigate this. McCall plans to conduct more
research to see if treating insomnia with sleep medication can reduce
the risk of suicide.
