Sleep disorders and suicidal ideation in patients with depressive disorder

Abstract

An intrinsic association between suicidal ideation and sleep disorders in patients with depressive disorder has been observed in recent studies. This study was conducted in order to examine the relationship between suicidal ideation and sleep disorders, such as insomnia and excessive sleepiness, in outpatients with major depressive disorder. Seventy patients with diagnoses of major depressive disorder were interviewed and assessed with the Sleep Habits Questionnaire and the Beck Scale for Suicidal Ideation (SSI). Data analyses were performed through descriptive analysis, Students t-test, Chi-square test and logistic regression model, with a statistical significance of 5%. In this study, depressed patients had high SSI scores (6.12 ± 2.67), particularly for active suicidal ideation (1.61 ± 0.39) and specific plans for suicide components (1.51 ± 0.40). Depressed patients with insomnia had significantly higher SSI scores (7.39 ± 2.84), in relation to patients with excessive sleepiness (3.68 ± 1.73). Furthermore it was observed that insomniac patients had significantly higher scores on the following components: active suicide ideation, specific plans for suicide and previous suicide attempts. The results of multivariate analysis showed that only insomnia had a significant association with suicidal ideation. Thus, sleep disturbances, particularly insomnia, should be considered in the assessment of suicidal risk in outpatients with depressive disorder.

The relationship between sleep quality, depression, and anxiety in patients with epilepsy and suicidal ideation

“…The "suicidal ideators" had the worst rates for quality of sleep (PSQI), sleep alterations (PSQI), global score (PSQI), anxiety (BAI), and depression (BDI), which allows us to suggest a strong association between anxiety and depression and sleep. Several studies have identified important relationships between sleep disorders, depression, suicidal ideation, and suicide 10,11,12,13,14,15 . Bernert and Joiner 13 observed that higher depression levels largely explained the relationship between sleep disorders and suicide.…”

“…Furthermore, our results revealed that depression (measured by the BDI) and sleep quality (as measured by the PSQI) were good predictors of suicidality in epilepsy. Considering these data, and recognizing that mood disorders 7 and sleep 10,11,12,13,14 are important risk factors for suicidal ideation and behavior, we recommend that the study and monitoring of these changes should be prioritized in the treatment of epilepsy, especially in cases of pharmaco-resistant epilepsy and/or psychiatric comorbidities.…”

“…Another important association is related to suicidal thoughts, behavior, and sleep disorders. The study of this association has advanced in recent years, and the results have demonstrated that suicidal ideation and behavior are closely associated with sleep disorders, such as insomnia, nightmares, daytime sleepiness, and difficulty initiating and maintaining sleep 10,11,12,13,14 . Furthermore, suicidal individuals demonstrate increased frequency and severity of several sleep disorders compared to non-suicidal individuals 15 .…”

Chronobiology, excessive daytime sleepiness and depression: Is there a link?

“…This unequivocal result was striking, considering that no specific relation of EDS with suicidal ideation had been previously described. An explanation for this finding may be that patients with severe depressive disorder rank daytime sleepiness in line with other major depressive symptoms [25][26][27]. If these findings are confirmed in a larger sample size, EDS should, therefore, be considered in the assessment of suicidal risk in depression.…”

Military Suicide Research Consortium

“…Cross-sectionally, insomnia has repeatedly been linked to greater levels of suicidal ideation (Ağargün et al, 1997a;Barraclough and Pallis, 1975) even after controlling for depressive symptoms (Bernert et al, 2005(Bernert et al, , 2009Chellappa and Araújo, 2007), and suicidal behavior (Goldstein et al, 2008;Sjöström et al, 2007). Longitudinal studies (though few) provide even more compelling evidence, indicating that insomnia emerges as a significant predictor of later suicidal ideation (McCall et al, 2010) and death by suicide (Fawcett et al, 1990;Fujino et al, 2005;Turvey et al, 2002).…”