Insomnia, psychiatric disorders and suicidal ideation in a National Representative Sample of active Canadian Forces members

Richardson, Julie; Thompson, Anthony Keith; King, Lisa; Corbett, Bradley A.; Shnaider, Philippe; Cyr, Kate St.; Nelson, Charles; Sareen, Jitender; Elhai, Jon D.; Zamorski, Mark A.

doi:10.1186/s12888-017-1372-5

Cited by 32 publications

(39 citation statements)

References 61 publications

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“…A growing body of research has shown that USA (US) military personnel are at elevated risk for insufficient sleep and poor sleep quality, with rates of sleep disturbance higher than rates in civilians (Klingaman, Brownlow, Boland, Mosti, & Gehrman, 2018;RAND Corporation;. These research findings are consistent with results of sleep study in Canadian and European military cohorts, although mixed results have also been reported (Danker-Hopfe et al, 2017;Pettersson, Saers, Lindberg, & Janson, 2016;Reijnen, Rademaker, Vermetten, & Geuze, 2015;Richardson, Thompson, & King et al, 2017). Based on a recent study that assessed pre-deployment psychosocial variables and insomnia complaints (defined as an Insomnia Severity Index ≥15; Morin, Belleville, Belanger, & Ivers, 2011) in soldiers located at Ft.…”

Section: Introductionmentioning

confidence: 69%

Sleep disturbance at pre-deployment is a significant predictor of post-deployment re-experiencing symptoms

Acheson

Kwan

Maihofer

et al. 2019

European Journal of Psychotraumatology

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Background: Insomnia is common in service members and associated with many mental and physical health problems. Recently, longitudinal data have been used to assess the impact of disturbed sleep on mental health outcomes. These studies have consistently shown relationships between sleep disturbance and development of mental illness. Objective: The present study examined the longitudinal relationship between sleep disturbance and PTSD symptomatology in a cohort of Marines and Navy Corpsmen deployed to Iraq and Afghanistan (n = 2,404) assessed prior to deployment, as well as at −3 and 6 months post-deployment. Additionally, we aimed to investigate the extent to which these relationships are moderated by combat-stress severity, and to what extent these findings are replicated in a second, separate cohort of Marines and Navy corpsmen (n = 938) assessed with identical measures prior to deployment and within 3 months of return. Method: The present study employed latent variable path models to examine the relationships between pre-deployment sleep disturbance and post-deployment reexperiencing symptoms. Initial cross-lagged path models were conducted on discovery and replication samples to validate the hypothesized predictive relationships. Follow up moderation path models were then conducted to include the effect of combat-stress severity on these relationships. Results: Initial cross-lagged models supported a significant relationship between predeployment sleep disturbance and future re-experiencing PTSD symptoms at all time points. Initial moderation models showed a small moderator effect of combat-stress severity, though the main predictive relationship between pre-deployment sleep disturbance and PTSD symptoms remained significant. The moderator effect was not significant in the replication sample. Conclusions: The results of this study support pre-deployment sleep disturbance as a risk factor for development of post-deployment PTSD symptoms. Interventions aimed at normalizing sleep may be important in preventive measures for PTSD.

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Section: Introductionmentioning

confidence: 69%

Sleep disturbance at pre-deployment is a significant predictor of post-deployment re-experiencing symptoms

Acheson

Kwan

Maihofer

et al. 2019

European Journal of Psychotraumatology

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“…Numerous studies have indicated that insomnia is associated with suicidal ideation [ 13 – 16 ], suicide attempts [ 17 – 19 ], and death by suicide [ 20 – 22 ] among adolescents and adults. These studies laid the foundation for the relationship between insomnia and suicide.…”

Section: Introductionmentioning

confidence: 99%

“…Some studies have found that the relationship between insomnia and suicide is fully mediated by mental disorders [ 13 , 14 , 24 ]. Other studies have shown that insomnia remains an independent factor of suicidal ideation [ 15 , 16 ], suicide attempt [ 19 ], and death by suicide [ 21 , 22 ] after adjustments for mental disorders, substance abuse and alcohol abuse.…”

Section: Introductionmentioning

confidence: 99%

Insomnia as an independent predictor of suicide attempts: a nationwide population-based retrospective cohort study

et al. 2018

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BackgroundNumerous studies have verified that insomnia is associated with suicidal ideation, suicide attempts, and death by suicide. Limited population-based cohort studies have been conducted to examine the association. The present study aimed to analyze whether insomnia increases the risk of suicide attempts and verify the effects of insomnia on suicide risk.MethodsThis study is a cohort study using 2000–2013 hospitalization data from the National Health Insurance Research Database (NHIRD) to track the rate of suicide attempts among insomnia patients aged 15 years or older. In addition, a 1:2 pairing based on sex, age, and date of hospitalization was conducted to identify the reference cohort (patients without insomnia). Cox proportional hazard model was used to assess the effects of insomnia on suicide risk.ResultsThe total number of hospitalized patients aged 15 years or older was 479,967 between 2000 and 2013 (159,989 patients with insomnia and 319,978 patients without insomnia). After adjusting for confounders, suicide risk in insomnia patients was 3.533-fold that of patients without insomnia (adjusted hazard ratio [HR] = 3.533, 95% confidence interval [CI] = 3.059–4.080, P < 0.001). Suicide risk in low-income patients was 1.434-fold (adjusted HR = 1.434, 95% CI = 1.184–1.736, P < 0.001) that of non-low-income patients. Suicide risk in patients with drug dependence and with mental disorders was 1.592-fold (adjusted HR = 1.592, 95% CI = 1.220–2.077, P < 0.001) and 4.483-fold (adjusted HR = 4.483, 95% CI = 3.934–5.109, P < 0.001) that of patients without drug dependence and without mental disorders, respectively. In the female population, suicide risk in insomnia patients was 4.186-fold (adjusted HR = 4.186, 95% CI = 3.429–5.111, P < 0.001) that of patients without insomnia. Among patients aged 25–44 years, suicide risk in insomnia patients was 5.546-fold (adjusted HR = 5.546, 95% CI = 4.236–7.262, P < 0.001) that of patients without insomnia. Furthermore, the suicide risk of insomnia patients with mental disorders was 18.322-fold that of patients without insomnia and mental disorders (P < 0.001).ConclusionInsomnia, low income, drug dependence, and mental disorders are independent risk factors for suicide attempts. Female patients and those aged 25–44 years are at high risk of suicide due to insomnia. Insomnia, mental disorders, and low income exhibit a synergistic effect on suicide attempts. Clinicians should pay attention to mental status and income level of insomnia patients.Electronic supplementary materialThe online version of this article (10.1186/s12888-018-1702-2) contains supplementary material, which is available to authorized users.

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“…Individuals in regional settings are vulnerable to a wide range of inequities of social circumstances, resource allocation, stigmatisation, and accessibility of healthcare [ 32 , 33 , 34 ], which could be implicated in this finding. Sleep disturbances is often used as a sensitive clinical marker of psychological distress, and has a dose-related relationship with developing and perpetuating late-life depression [ 35 ], as well as suicidal ideation [ 36 ]; and appears to be a moderate risk factor in this population. Life-time suicidal behaviours and late-life suicidal ideation are strongly predictive of late-life depression, as revealed clinically and in the literature [ 37 , 38 ].…”

Section: Discussionmentioning

confidence: 99%

Depression, Suicidal Behaviour, and Mental Disorders in Older Aboriginal Australians

Shen

Radford

Daylight

et al. 2018

IJERPH

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Aboriginal Australians experience higher levels of psychological distress, which may develop from the long-term sequelae of social determinants and adversities in early and mid-life. There is little evidence available on the impact of these on the mental health of older Aboriginal Australians. This study enrolled 336 Aboriginal Australian participants over 60 years from 5 major urban and regional areas in NSW, utilizing a structured interview on social determinants, and life-time history of physical and mental conditions; current psychosocial determinants and mental health. Univariate and multivariate analyses were utilized to examine the link between these determinants and current depressive scores and suicidality. There was a high rate of life-time depression (33.3%), current late-life depression (18.1%), and suicidal ideation (11.1%). Risk factors strongly associated with late-life depression included sleep disturbances, a history of suicidal behaviour, suicidal ideation in late-life and living in a regional location. This study supports certain historical and psychosocial factors predicting later depression in old age, and highlights areas to target for prevention strategies.

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Insomnia, psychiatric disorders and suicidal ideation in a National Representative Sample of active Canadian Forces members

Cited by 32 publications

References 61 publications

Sleep disturbance at pre-deployment is a significant predictor of post-deployment re-experiencing symptoms

Sleep disturbance at pre-deployment is a significant predictor of post-deployment re-experiencing symptoms

Insomnia as an independent predictor of suicide attempts: a nationwide population-based retrospective cohort study

Depression, Suicidal Behaviour, and Mental Disorders in Older Aboriginal Australians

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