Suicidal ideation in Veterans misusing alcohol: Relationships with insomnia symptoms and sleep duration

Abstract

Objective The aim of this investigation was to assess the relationships between suicidal ideation and insomnia symptoms in Veterans misusing alcohol. Method Data were extracted in this retrospective chart review of Veterans referred from primary care for a behavioral health evaluation (N = 161) based on evidence of heavy drinking, drug use or another behavioral problem. Suicidal ideation (SI) was assessed using the Paykel questionnaire. Insomnia symptoms were assessed with standard diary questions in an interview format and pertained to sleep latency (SL), wake after sleep onset time (WASO), sleep quality (SQ), and habitual sleep duration (HSD). The relations between suicidal ideation and insomnia symptoms were assessed using ordinal regression analyses adjusted for socio-demographic, psychiatric and addiction-related variables. Results Suicidal ideation was reported in 62 (39%) of the Veterans interviewed. In a multivariable model, only inadequate SQ was associated with suicidal ideation. Short sleepers were more likely to endorse suicidal ideation and have attempted suicide in the past year. In addition, older age, inadequate financial status, and the presence of a psychiatric disorder were also significantly associated with suicidal ideation in most of the adjusted models. Conclusion Given their association with suicidal ideation, insomnia symptoms in Veterans misusing alcohol should prompt an assessment of underlying psychiatric and social factors.

Clinical Feasibility of a Just-in-Time Adaptive Intervention App (iREST) as a Behavioral Sleep Treatment in a Military Population: Feasibility Comparative Effectiveness Study (Preprint)

“…Last, digital interventions such as JITAI allow seamless integration of patients' clinical progresses and outcomes into the electronic health record (EHR) system of medical centers or clinics and patients' own personal health record (PHR). This integration is important in maintaining the continuous of care, especially since insomnia is highly comorbid with other health and psychological conditions [4,36,37].…”

“…When these sleep disturbances occur before and after deployment, they mark robust risk factors for poor psychological health, including Post Traumatic Syndrome Disorder (PTSD), major depressive disorder, suicidal tendencies, hazardous alcohol use, and addictive disorders [4][5][6]. Sleep disturbances also impede response to treatment for those aforementioned conditions and increase the risk of onset or recurrence [7].…”

Die Bedeutung von Schlafstörungen für die Prävention von Suizidalität

“…Auch in klinischen Populationen wurden Zusammenhänge von Kurzschlaf und dem Schweregrad suizidalen Verhaltens bei Frauen und Suizidversuchen bei Männern ermittelt [1]. Bei Kriegsveteranen mit Alkoholmissbrauch waren Kurzschläfer für Suizidgedanken und -versuche stärker gefährdet [28]. Eine koreanische Bevölkerungsstu-die belegt ein U-förmiges Risikomuster bei Kurz-(hier < 5 Stunden) und Langschläfern (> 9 Stunden) für Suizidgedanken gegenüber Befragten mit 7 Stunden Nachtschlaf [53], ähnlich auch [43].…”

Short Sleep Duration and Circadian Rhythms: Association with Suicidal Behaviour

“…Short sleep seems to have deleterious effects on cognition and behaviour. Namely, it causes an impairment on the individual's problem-solving and decision-making abilities, judgement, concentration, emotional regulation, and impulse control, thereby promoting states of anxiety, hostility/aggressiveness, frustration, catastrophic thinking, hopelessness, depressed mood and rumination [9,15,17,21,26,33,34,38]. These factors are all considered to influence the development of suicidal behaviours.…”