In an interesting study recently, sleep disturbances were found to be a significant short-term risk factor leading to suicidal thoughts in young adults with a history of suicidal ideation.1 Sleep changes were seen to correlate to worsening suicidal thoughts regardless of the individual’s depression severity – specifically, variations in bedtime and wake up time.
Suicide More Prevalent Among Teens and Young Adults
Suicide is widely acknowledged as more prevalent among teens and young adults – in fact, the CDC lists it as the second leading cause of death among young adults. Sleep problems are also common within this age demographic, and have been thought to be a risk factor for suicide. Though the interplay of the 2 factors has never been researched objectively as a short-term indicator of risk before.
The study analyzed both self-reported sleep characteristics and objective sleep profiles – using actigraphy – of 50 young adults (18-23) at high risk for suicide. The participants were selected from a group of 5,000 undergraduate students, and all had a history of suicide attempts, or recent suicidal ideation. For 1 week, participants wore a watch-like device to bed that measured wrist movements – actigraphy is a validated way to measure sleep-wake patterns. Questionnaires measuring suicidal severity, insomnia, nightmares, depression and alcohol use were obtained at the onset of the study and at 7 and 21 days.
Sleep – Wake Times Correlated with Suicidal Ideation
Individuals with the greatest amount of variability in sleep and wake times also had more severe experiences of suicidal ideation at the 7 and 21-day check-ins. Falling asleep at very different times seemed to be especially predictive of an increase in suicidal ideation. This correlation was seen independent of the participants’ severity of depression, substance use, or the severity of symptoms at the onset of the study.
Assessing Sleep Quality
Sleep disturbances, depression and suicidal thoughts are certainly entangled factors to many individuals’ mental health picture. Untangling them may not be any easier with this research, however, having independent risk factors, such as sleep quality, which are non-stigmatizing and very treatable, are important to sifting through the layers of these complex issues.
1) Bernert RA, Hom MA, Iwata NG, Joiner TE. Objectively Assessed Sleep Variability as an Acute Warning Sign of Suicidal Ideation in a Longitudinal Evaluation of Young Adults at High Suicide Risk. J Clin Psychiatry. 2017;78(6):e678-e687.
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Node Smith, associate editor for NDNR, is a fifth year naturopathic medical student at NUNM, where he has been instrumental in maintaining a firm connection to the philosophy and heritage of naturopathic medicine among the next generation of docs. He helped found the first multi-generational experiential retreat, which brings elders, alumni, and students together for a weekend camp out where naturopathic medicine and medical philosophy are experienced in nature. Three years ago he helped found the non-profit, Association for Naturopathic ReVitalization (ANR), for which he serves as the board chairman. ANR has a mission to inspire health practitioners to embody the naturopathic principles through experiential education. Node also has a firm belief that the next era of naturopathic medicine will see a resurgence of in-patient facilities which use fasting, earthing, hydrotherapy and homeopathy to bring people back from chronic diseases of modern living; he is involved in numerous conversations and projects to bring about this vision.