Sleep Disorders

18 June 2007

Bad sleep tied to suicide

Chronically troubled sleep may be a marker for an increased risk for suicide in the elderly, a new report suggests.

Chronically troubled sleep may be a marker for an increased risk for suicide in the elderly, a new report suggests.

"The association exists even after you control for depression," said lead researcher Rebecca Bernert, a clinical psychology doctoral student at Florida State University. "This finding is important, because sleep disturbances are amenable to treatment, unlike other risk factors, such as past suicide attempts. Sleep problems can be undone," she said.

Bernert was scheduled to present the findings on Thursday at the annual meeting of the Associated Professional Sleep Societies, in Minneapolis.

In the study, Bernert reviewed health data on almost 14 500 elderly people aged 67 to 90 years old, tracked over a 10-year period.

During this period, 21 individuals committed suicide. When each suicide was matched to 20 randomly-selected controls, the researchers found that sleep disturbances, independent of depression, predicted an increased risk for eventual death by suicide.

Gregg Jacobs, an insomnia specialist with the University of Massachusetts Memorial Medical Centre in Worcester, urged caution in attributing the existence of sleep problems, by itself, to an increase in suicide risk.

A complex relationship
"The relationship between sleep problems and mortality is a complex one," he said. "Stress, for instance, is co-founded with insomnia, and it is really the stress causing the increased risk ... not just not sleeping well," Jacobs noted.

Studies also suggest that regular use of sleeping pills - strongly linked to insomnia, of course - also increases the risk for suicide. Those having trouble sleeping also sometimes use alcohol and drugs to self-medicate, and these abuses can raise the risk of mortality, Jacobs said.

Bernert and her colleagues assessed five types of self-reported sleep complaints in their report: non-restorative sleep, which meant that people may have had a full night's sleep but did not feel rested upon awakening; difficulty falling asleep; difficulty staying asleep; early-morning awakenings, and feelings of restlessness during the day.

When people reported suffering from non-restorative sleep, for instance, Bernert said, "They were almost twice as likely to complete suicide compared to those without this particular sleep complaint. This relationship existed even after controlling for depression."

However, she added, because the number of suicide victims in this study was small, the finding should be interpreted with caution, and more research is needed to investigate specific sleep complaints in the prediction of suicide.

How might sleep problems impact suicide risk?

Sleep may impact on mood
"It's pure speculation, but sleep may play an important role in regulating moods," Bernert said. Having insufficient sleep can adversely affect someone's mood, she said.

Insomnia, the most common sleep complaint, affects approximately 48 percent of older adults, according to the National Sleep Foundation.

Older adults should get seven or eight hours of sleep a night, Bernert said, but many report that they have trouble falling asleep and so get less sleep than they need. Some problems associated with sleeplessness include memory and attention problems, depressed moods, excessive daytime drowsiness, more night-time falls and reliance on over-the-counter or prescription sleep aids.

If an older person is having sleep problems, they shouldn't assume it's just an inevitable part of ageing, Bernert added.

"It's important for each individual to see a sleep specialist," she said, because treatment is available and effective. – (HealthDayNews)

Read more:
Sleep Centre
Depression Centre

June 2007


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Dr Alison Bentley is a general practitioner who has consulted in sleep medicine and sleep disorders, in both adults and children of all ages, for almost 30 years. She also researches and publishes on a number of sleep-related topics both in formal research journals and lay publications including as editor of Sleep Matters, an educational newsletter on sleep disorders for doctors.

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