Insomnia, psychiatric disorders and suicidal ideation in a national representative sample of active Canadian Forces members

Abstract

Background Past research on the association between insomnia and suicidal ideation (SI) has produced mixed findings. The current study explored the relationship between insomnia, SI, and past-year mental health status among a large Canadian Forces (CF) sample. Method Data was obtained from the 2013 Canadian Forces Mental Health Survey (CFMHS), and included a large representative sample of Canadian Regular Forces personnel (N = 6700). A series of univariate logistic regressions were conducted to test individual associations between past-year mental health status, insomnia, and potential confounds and SI. Mental health status included three groups: 0, 1, or two or more probable diagnoses of posttraumatic stress disorder (PTSD), major depressive disorder (MDD), generalized anxiety disorder (GAD), panic disorder (PD) and alcohol abuse/dependence. Stepwise multivariate logistic regression was used to assess the relationship between insomnia and SI with mental health status as a moderator. Results 40.8% of respondents reported experiencing insomnia. Both insomnia and number of mental health conditions incrementally increased the risk of SI. However, past-year mental health status was a significant moderator of this relationship, such that for CF personnel with either no (AOR = 1.61, 1.37–1.89) or only one past-year mental health condition (AOR = 1.39, 1.12–1.73), an incremental increase in insomnia was associated with an increased likelihood of SI. However, in personnel with two or more past-year mental health disorders, insomnia was no longer significantly associated with SI (AOR = 1.04, 0.81–1.33). Conclusions Insomnia significantly increased the odds of SI, but only among individuals with no or one mental health condition. Findings highlight the importance of assessing insomnia among CF members in order to further suicide prevention efforts.

The aberrant dynamic amplitude of low-frequency fluctuations in melancholic major depressive disorder with insomnia

“…Sleep disturbances, particularly insomnia, are prevalent and prodromal clinical characteristics in MDD (3), and 92% of patients with major depressive episodes reported substantial sleep complaints (4). Insomnia, as one of the main manifestations of sleep disturbances, is not only an important risk factor for developing depression (5,6) but also for recurrence (7), and its severity is associated with the quality of life (8), the severity of depression (8), the therapeutic effect (9, 10), and suicidal thoughts (11,12). In addition, the link between MDD and insomnia showed a strong bond based on substantial shared genetic liability (13,14).…”

You lack the season of all natures, sleepCommentary on Miller BJ, McCall WV. Insomnia and suicide as reported adverse effects of second-generation antipsychotics and mood stabilizers. J Clin Sleep Med . 2022;18(2):517–522. doi:10.5664/jcsm.9646

“…More than 48,000 deaths by suicide were reported per year in the United States and this number is probably underreported. 1 Innumerable studies have validated that insomnia is linked to suicidal ideation, [2][3][4] suicide attempts, [5][6][7] and death by suicide. [8][9][10] A nationwide cohort study from China that was published in 2018 remarked that suicide risk in patients with insomnia was 3.533-fold that of patients without insomnia.…”