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Nightmares predict elevated suicidal symptoms

WESTCHESTER, Ill. — Self-reported nightmares among patients seeking emergency psychiatric evaluation uniquely predicted elevated suicidal symptoms, according to a research abstract that will be presented on Tuesday, June 9, at SLEEP 2009, the 23rd Annual Meeting of the Associated Professional Sleep Societies.

Results indicate that severe nightmares were independently associated with elevated suicidal symptoms after accounting for the influence of depression, whereas symptoms of insomnia were not. These findings suggest that nightmares stand alone as a suicide risk factor.

The sample included 82 men and women between the ages of 18 and 66, who were in a community mental health hospital admissions unit awaiting an emergency psychiatric evaluation. Evaluations determined eligibility for crisis stabilization inpatient admittance. Patients’ nightmares, insomnia, depression and suicidal tendencies were assessed through several questionnaires, including the Disturbing Dreams and Nightmare Severity Index, Insomnia Severity Index (ISI), Beck Depression Inventory (BDI), and the Beck Scale for Suicide Ideation (BSS).

According to principal investigator, Rebecca Bernert, doctoral candidate in clinical psychology at Florida State University, findings of the study emphasize the need for a more thorough assessment of sleep among acutely-ill patients, as it may be an important opportunity for intervention.

“Sleep disturbances, especially nightmares, appear to be an acute warning sign and risk factor for suicide,” said Bernert. “Given that poor sleep is amenable to treatment, and less stigmatized than depression and suicide, our findings could impact standardized suicide risk assessment and prevention efforts.”

The study states that sleep complaints are now listed among the top 10 warning signs of suicide by the Substance Abuse and Mental Health Services Administration (SAMHSA).

Sleep and mood disturbances are closely related, and depression is the single best predictor of suicide.

People who suffer from persistent sleep problems should consult a sleep expert at one of the 1,600 centers accredited by the American Academy of Sleep Medicine (AASM). Those experiencing a suicidal crisis or emotional distress are encouraged to contact the National Suicide Prevention Lifeline toll-free at 1-800-273-TALK, which offers a 24-hour crisis hotline.

The annual SLEEP meeting brings together an international body of 6,000 leading researchers and clinicians in the field of sleep medicine to present and discuss new findings and medical developments related to sleep and sleep disorders.

More than 1,300 research abstracts will be presented at the SLEEP meeting, a joint venture of the AASM and the Sleep Research Society. The three-and-a-half-day scientific meeting will bring to light new findings that enhance the understanding of the processes of sleep and aid the diagnosis and treatment of sleep disorders such as insomnia, narcolepsy and sleep apnea.

Abstract Title: Insomnia and Nightmares as Predictors of Elevated Suicide Risk Among Patients Seeking Admission to Emergency Mental Health Facility

Presentation Date: Tuesday, June 9

Category: Sleep in Psychiatric Disorders

Abstract ID: 1120

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