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Adults who suffer chronic sleep problems may be more likely to try to commit
suicide, US research suggests.
Doctors are being warned to be vigilant if a patient reports disturbed sleep -
even if they have no history of mental health problems.
The more types of sleep disturbances people had, the more likely they were to
have thoughts of killing themselves, or actually try to do so.
The study will be presented at a World Psychiatric Association meeting.
This study reinforces the fact that good sleep is vital for good physical,
mental and emotional health
Dr Neil Stanley Norfolk and Norwich University Hospital
The World Health Organization estimates that about 877,000 people worldwide die
by suicide every year. For every death up to 40 suicide attempts are made.
Scientists have consistently linked sleep disturbances to an increased risk of
suicidal behaviour in people with psychiatric disorders and in adolescents.
But it has been unclear whether the association also exists in the general
adult population.
Sleep disturbance
A University of Michigan team examined the relationship over one year between
sleep problems, and suicidal behaviour in 5,692 Americans. During the course of
the year 2.6% of the sample had suicidal thoughts, and 0.5% were recorded as
making a suicide attempt.
INSOMNIA
They looked at three types of sleep problems - difficulty falling asleep,
difficulty staying asleep and waking at least two hours earlier than desired.
The researchers took account of factors such as substance abuse, depression,
anxiety disorder, and physical illness, as well as social factors such as
marriage and financial status.
People with two or more symptoms of insomnia were 2.6 times more likely to
report a suicide attempt than those whose sleep was not disturbed.
Early morning waking was the single trait most strongly linked to suicidal
behaviour.
Lead researcher Dr Marcin Wojnar said: "The presence of sleep problems should
alert doctors to assess such patients for a heightened risk of suicide even if
they don't have a psychiatric condition.
"Our findings also raise the possibility that addressing sleep problems could
reduce the risk of suicidal behaviours."
Underlying link
Dr Wojnar said it was possible that sleep disorders and suicidal thoughts were
both the manifestation of a troubled psyche, or that poor sleep drove people to
thoughts of suicide.
Most people with insomnia manage the effects very well
Dr Daniel Freeman Institute of Psychiatry at King's College London
But he also suggested there could be an underlying physiological link between
the two which was not clear.
Experts have suggested that a lack of sleep might affect the way the brain
works, leading to poor judgement and less ability to control impulses.
It is also suspected that both sleep disorders and suicidal thoughts might be
linked to an imbalance in the chemical serotonin, which plays a key role in
regulating mood.
Dr Daniel Freeman, of the Institute of Psychiatry at King's College London,
said the study showed that insomnia was very common, and could have a
significant effect on psychological well-being.
He said: "It is very plausible that suicidal thoughts, which happen when we are
depressed and find it hard to think our way out of our problems, have been
linked to insomnia.
"However it needs to be remembered that insomnia is very common and suicidal
thoughts less so. Most people with insomnia manage the effects very well.
"Insomnia only triggers severe problems for people with a pre-existing
vulnerability."
Sleep important
Dr Neil Stanley, a sleep expert at Norfolk and Norwich University Hospital,
said: "This study reinforces the fact that good sleep is vital for good
physical, mental and emotional health.
"Poor sleep has long been linked with an increased risk of depression, but this
study suggests that the increased risk of suicidal behaviour is not necessarily
linked to depression and thus can affect those that doctors might not feel are
at risk.
"It is another demonstration of the importance, both as an individual and as a
society, of getting good sleep."