Sleep problems have been identified as a great risk for suicidal thoughts, plans and attempts. A new study found that the link between nightmares and suicidal behavior is mediated in part in a multistep pathway through impaired cognitive strategies. The results showed that suicidal thoughts, plans, or attempts were present in 62% of those who had nightmares, and only 20% of those who did not see nightmares.
Multiple analyzes have suggested that nightmares act as a stressor in people who have experienced short- or long-term traumatic situations that are often the cause of PTSD. Nightmares can trigger certain types of negative thinking, including depression, hopelessness, which reinforce suicidal thoughts and behavior. The association between nightmares and suicidal behavior is most commonly seen regardless of comorbid insomnia and depression.
The post-stress period following traumatic situations increases the risk of suicidal thoughts and behavior, and this study shows that nightmares are a hallmark of trauma survivors. This could be important in treatment and help reduce the risk of suicide, said research leader Donna L. Littlewood, M. D. from the University of Manchester.
This study emphasizes the importance of a concrete assessment of the presence of nightmares in trauma survivors. In addition, monitoring and targeting the level of severity of negative cognitive manifestations, such as depression, detachment, fixation, hopelessness, can lead to a decrease in suicidal thoughts and behavior.
The American Academy of Sleep Medicine reports that nightmares are vivid, realistic, and unsettling in dreams, usually associated with threats to survival or safety, which often elicit emotions of anxiety, fear, or terror. Sleep disturbances can occur when recurring nightmares cause distress or disruption to social or professional performance.
Nightmares lasting three months after trauma are present in 80% of PTSD patients, and these PTSD nightmares can persist throughout life. Data for this study was collected from 91 study participants who experienced traumatic events. Of these, 51 had PTSD criteria recorded during the study.
The nightmares were analyzed by adding frequency and intensity. Participants also completed a questionnaire on suicidal behavior, depression and other disorders. Taking into account the relationship between insomnia and suicide, the involvement of insomnia in this was noted as covarian (ambivalent, in some cases decisive). The analysis was also performed for those participants who had coexisting depression.
This study was led by Simon D. Kyle, Ph. D., of the Institute of Sleep and Circadian Neurology at the University of Oxford. The authors suggest that there are additional pathways underlying the relationship between nightmares and suicide that need to be identified in future research.
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