Non-Constructive Ruminations, Insomnia and Nightmares: Trio of Vulnerabilities to Suicide Risk

Abstract

Objective Nightmare distress, nightmare frequency and anxiety are related to suicidal risk. Ruminations are a factor maximizing the risk of suicide. Research has identified two types of ruminations: constructive ruminations and non-constructive ruminations. As per our knowledge, no study has verified the links between non-constructive ruminations and sleep disorders and their role in the development of suicidal risk. We aimed to highlight the impact of non-constructive ruminations on nightmares, anxiety and insomnia in the development of suicidal risk. Methods A total of 429 French participants responded to an anonymous online survey using the Qualtrics ® software. To assess variables, we used the Mini Cambridge-Exeter Repetitive Thought Scale, the Suicide Behaviors Questionnaire-Revised, the Nightmare Distress Questionnaire, the Beck Anxiety Inventory, and the Sleep Condition Indicator. Nightmare frequency was assessed by subjective evaluation through a question. We tested the possible effects of confounding variables such as age, gender, marital status and depression (Beck Depression Inventory-II). Results Nightmare frequency was found to mediate the link between anxiety and suicidal risk (32.9%). Nightmare distress (37%) and non-constructive thoughts (48%) were also seen to mediate this link. Additionally, we found a moderating effect of insomnia on the link between non-constructive ruminations and suicidal risk (Z = 7.42, p < 0.001). Conclusion Our results showed that the frequency of nightmares, distress and non-constructive ruminations are closely related to suicidal risk. The interoperability between these elements and insomnia has thus been newly explored. The processes related to nightmares and suicidal risk as well as the underlying cognitive processes between sleep disorders and suicidal risk have been shed light upon.

Beliefs about sleep: links with ruminations, nightmare, and anxiety

“…These correlation analyses were conducted for good sleepers and poor sleepers respectively. The results showed homogeneity between the two groups andare consistent with the existing scientific literature [ 8 , 13 ]. In addition, constructive ruminations were negatively associated with dysfunctional beliefs about sleep and anxiety.…”

“…Few studies differentiate between types of rumination and their distinct links in relation to sleep disorders. Faccini et al [ 13 ] have shown that only non-constructive ruminations are associated with nightmare distress, insomnia and increased psychopathological risk including suicidal risk in the general population. Tighe et al [ 14 ] have highlighted in their work that it is important to distinguish between different types of repetitive thinking.…”

Impact of sleep dysfunction on psychological burden in patients with empty nose syndrome

“…Further, sleep symptoms can cause great distress and may increase the risk of suicidal ideation. 6 Thus, there is a need for more successful management of sleep disturbance in subjects suffering from anxiety and depression. data and drafted the manuscript.…”

“…People with insomnia usually experience greater levels of depression and anxiety. Further, sleep symptoms can cause great distress and may increase the risk of suicidal ideation 6 . Thus, there is a need for more successful management of sleep disturbance in subjects suffering from anxiety and depression.…”

Insomniac symptoms and suicidality—link and management

“…Oft begegnen sie diesem Wunsch bereits frühzeitig durch dysfunktionales Verhalten, wie Schlafperioden tagsüber oder besonders frühe Bettzeiten, wodurch es aber nur zu einer Verstärkung des „insomnischen Teufelskreises“ mit vermehrtem Wachliegen, Grübeln, steigender Anspannung und Suizidalität kommt. Gleichzeitig berichten Patienten mit nächtlichem „nicht-konstruktivem Grübeln“ gehäuft über kombinierte insomnische Symptome und Suizidalität, oft auch im Zusammenhang mit Albträumen [ 18 ].…”