Sleepless nights can boost the risk of suicide. That’s the conclusion of a new Medical College of Georgia study that suggests people who lose hope that they will ever get another good night's sleep are at much higher risk for taking their own lives.
"It turns out insomnia can lead to a very specific type of hopelessness and hopelessness by itself is a powerful predictor of suicide," said researcher W. Vaughn McCall, M.D., chair of the MCG Department of Psychiatry and Health Behavior at Georgia Regents University. "It's fascinating because what it tells you is we have discovered a new predictor for suicidal thinking."
The new study — reported in the Journal of Clinical Sleep Medicine, published by the American Academy of Sleep Medicine — confirms past research that has shown insomnia and nightmares are both risk factors for suicide. But McCall and colleagues also discovered that the added element of hopelessness about sleep is also a major risk factor, and is independent of other types of hopelessness, such as those regarding personal relationships and careers.
McCall said the findings identify another important suicide risk factor and suggest targeting the negative thoughts with pharmaceuticals and psychological therapy may help. They should also prompt physicians to ask depressed patients with sleep problems if they are having suicidal thoughts, McCall said.
The findings are based on an analysis of 50 depressed patients, aged 20 to 80 years. More than half had attempted suicide and most were taking an antidepressant. McCall and colleagues were able to identify the relationship between insomnia and suicide risk, by asking specific questions such as: “Do you think you will ever sleep again?”
McCall, who specializes in depression and sleep disorders, said he's seen insomnia patients develop dire thoughts about not sleeping — believing, for example, that their immune system is being hopelessly damaged.
Once insomnia has been diagnosed, he urges the following strategies to help people get to sleep:
- Wake up at the same time every day no matter when you go to bed.
- Don't go to bed until you are sleepy.
- Eliminate caffeine, which can stay in your system up to 15 hours.
- Cut alcoholic beverages or tobacco use.
- Engage in cardiovascular exercise at least four hours before bedtime.
- Allow ample time to digest a meal before heading to bed.
"If you talk with depressed people, they really feel like they have failed at so many things. It goes something like, 'My marriage is a mess, I hate my job, I can't communicate with my kids, I can't even sleep.' There is a sense of failure and hopelessness that now runs from top to bottom and this is one more thing," McCall said.
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