When people lose hope they will ever get another good night’s sleep, their risk of suicide spikes, according to a new study.
Insomnia and nightmares, which are often confused and may go hand-in-hand, are known risk factors for suicide, according to Dr. W. Vaughn McCall, chair of the Medical College of Georgia at Georgia Regents University.
He notes the new study reaffirms that link and adds another element: Hopelessness about sleep independent of other types of hopelessness, such as those about personal relationships and careers.
“It turns out insomnia can lead to a very specific type of hopelessness, and hopelessness by itself is a powerful predictor of suicide,” he said.
The likelihood of being suicidal at least doubles when insomnia is a symptom, McCall added.
“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.
For the study, researchers assessed the mental state of 50 depressed patients between the ages of 20 and 80. More than half had attempted suicide and most were taking an antidepressant.
The testing enabled the researchers to filter out other suicide risks, such as depression itself, and hone in on the relationship between insomnia and suicide risk, with researchers asking specific questions about dysfunctional beliefs about sleep, such as: Do you think you will ever sleep again?
“It was this dysfunctional thinking — all these negative thoughts about sleep — that was the mediating factor that explained why insomnia was linked to suicide,” said McCall, who specializes in depression and sleep disorders.
He said he’s seen insomnia patients spiral downward with increasingly negative and unrealistic thoughts about not sleeping; thinking, for example, that their immune system is being irrevocably damaged.
McCall challenges such thoughts and asks other doctors to consider doing the same: To disagree, strongly stating there is no scientific evidence for the thoughts, but there is hope and help. “People have choices,” he said.
Once insomnia has been diagnosed, some fairly rigid guidelines can help turn the exhausting and potentially deadly tide, he said. These include:
- Waking up at the same time every day no matter when you go to bed;
- Not going to bed until you are sleepy;
- Eliminating caffeine, known to stay in your system up to 15 hours;
- Eliminating alcoholic beverages or tobacco products;
- Completing cardiovascular exercise at least four hours before bedtime;
- And allowing ample time to digest a meal before heading to bed.
The study is published in the Journal of Clinical Sleep Medicine.