Sleep Disturbances and Suicidal Behavior
Sleep disturbances, particularly insomnia, nightmares, and excessive daytime sleepiness (EDS), are significant, proximal, and modifiable risk factors for suicidal ideation and behaviors (SIB) and could be targeted for preventative interventions. In this c
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Contents 1 Introduction 2 Method 3 Sleep Complaints in the General Population 3.1 Insomnia 3.2 Excessive Daytime Sleepiness 3.3 Nightmares 4 Sleep Disturbances in Psychiatric Conditions 5 Effects of Insomnia on SIB 6 Effects of Nightmares on Suicidality 7 Effects of Excessive Daytime Sleepiness on Suicidality 8 Role of Confounders in the Relationship Between Sleep Disturbances and SIB 9 Mechanisms Underlying the Association Between Sleep Disturbances and SIB 10 Perspectives References
Abstract Sleep disturbances, particularly insomnia, nightmares, and excessive daytime sleepiness (EDS), are significant, proximal, and modifiable risk factors for suicidal ideation and behaviors (SIB) and could be targeted for preventative interventions. In this chapter, we review the evidence supporting the association of insomnia, nightmares, and EDS with SIB. We also describe these sleep disturbances in the general population, as well as their association with psychiatric disorders. A PubMed search was conducted to identify the relevant literature. Insomnia is very frequent across mental disorders, but SIB patients are particularly exposed. Specific interventions focused on insomnia are useful in contending suicidal ideation.
J. Lopez-Castroman (*) PSNREC, University of Montpellier, INSERM, Montpellier, France Nimes University Hospital, Nimes, France CIBERSAM, Madrid, Spain I. Jaussent PSNREC, University of Montpellier, INSERM, Montpellier, France © Springer Nature Switzerland AG 2020 Curr Topics Behav Neurosci https://doi.org/10.1007/7854_2020_166
J. Lopez-Castroman and I. Jaussent
Nightmares seem to constitute an independent risk factor for SIB, beyond insomnia, particularly in young people and when experienced frequently. The evidence regarding the association of EDS and SIB is less clear and probably explained by the reduction of health-related quality of life and comorbid depression. The mechanisms underlying the relationship between sleep disturbances and SIB as well as the role of potential confounders and future perspectives in this field are also discussed. Keywords Dyssomnias · Self-injurious behavior · Sleep deprivation · Sleep disorders · Sleep hygiene · Suicide attempt
1 Introduction Suicidal ideation and behaviors (SIB) are part of a complex, multifactorial phenomenon that spans over biological, social, and psychological mechanisms. The prevention of SIB has become a public health priority in many countries, but to date the results of prevention programs are insufficient (Hedegaard et al. 2018). If there is to be any progress in understanding suicide, significant, proximal, and modifiable risk factors should be identified. Through the last decades, numerous studies suggest that sleep disturbances, particularly insomnia, nightmares, and excessive daytime sleepiness (EDS), are among such factors (Porras-Segovia et al. 2019; Littlewood et al. 2017; Bernert et al. 2015; Pigeon et al. 2012). First, sleep disturbances are strongly associated with all the different components of the suicidal process. Second, they very often co
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