Insomnia, nightmares, and erratic sleep times could be indicators of worsening suicidal thoughts among young adults, a new study suggests.
Researchers found that young adults who experienced sleep disturbances were more likely to have suicidal thoughts over the subsequent 3 weeks, compared with young adults who slept well.
Lead author Rebecca Bernert, Ph.D., assistant professor of psychiatry and behavioral sciences at Stanford University in California, and colleagues recently reported their findings in the Journal of Clinical Psychiatry.
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Needless to say, suicide is a major public health concern, and there is a need to identify risk factors for suicide, so that preventive measures can be put in place.
The new study from Dr. Bernert and team suggests that sleep disturbances could be one such factor.
To reach their findings, the researchers enrolled 50 adults aged 18 to 23 years old. All participants either had a history of suicide attempts or had recent thoughts of suicide.
For 1 week, participants were required to wear an accelerometer on their wrist each night. This enabled the researchers to monitor their wrist movements, which previous research has shown is a reliable indicator of sleep-wake patterns.
The participants also completed questionnaires detailing the severity of insomnia, nightmares, depression, alcohol intake, and suicidal thoughts. Questionnaires were completed at study baseline, as well as 1 and 3 weeks after sleep monitoring.
Compared with participants who fell asleep and awoke at similar times each day, those who had greater variability in their sleep and wake times – particularly the former – were more likely to have suicidal thoughts 1 and 3 weeks later.
What is more, subjects who had greater variability in sleep times were also more likely to experience insomnia and nightmares, and both of these were independent predictors of suicidal thoughts.
“Insomnia and nightmares beget more variability in when we are able to then fall asleep on subsequent nights, which speaks to the way in which insomnia develops,” notes Dr. Bernert.
“Sleep is a barometer of our well-being, and directly impacts how we feel the next day,” she adds. “We believe poor sleep may fail to provide an emotional respite during times of distress, impacting how we regulate our mood, and thereby lowering the threshold for suicidal behaviors.”
Even after accounting for the severity of depression among participants, the link between sleep disturbances and suicidal thoughts remained.
Based on their findings, Dr. Bernert and team believe that insomnia, variability in sleep-wake times, and other sleep disturbances may be a predictor of suicidal thoughts among young adults – a population most commonly affected by suicide.
As Dr. Bernert says, sleep disturbances “may represent an important treatment target in suicide prevention.”
The team is already in the process of conducting two clinical trials, in which non-drug treatments for insomnia are being tested for their efficacy in preventing suicidal behaviors.
“Compared to other risk factors for suicide, disturbed sleep is modifiable and highly treatable using brief, fast-acting interventions,” says Dr. Bernert.
“Because sleep is something we universally experience, and we may be more willing to openly talk about it relative to our mental health, we believe its study may represent an important opportunity for suicide prevention.”
Rebecca Bernert, Ph.D.