Unpacking Sleep and Suicide in Older Adults in a Combined Online Sample

Abstract

BRIEF SUMMARYCurrent Knowledge/Study Rationale: Research has shown relations between duration of insomnia symptoms/duration of nightmares and suicide risk in younger adults. However, this relation has not been examined in older adults. Study Impact: The present study found that, in older adults, nightmare duration was related to suicide risk independent of current nightmares, current symptoms of and duration of insomnia, and symptoms of anhedonia and PTSD. Nightmare duration was also related to suicide risk independent of the IPTS. Thus, nightmare duration is an important factor to be assessed when evaluating the level of suicide risk with patients.Objective: Duration of insomnia symptoms and nightmares are related to suicidal risk in young adults independent of current symptoms of insomnia, nightmares, anxiety, depression, and PTSD. However, this relation has yet to be examined among older adults, despite older adults being at higher risk of suicidal behavior. Further, the current study aims to replicate previous research among younger adults showing that insomnia symptoms and nightmares are associated with suicide risk independent of the interpersonal psychological theory of suicide (IPTS). Methods: The present study utilized 167 participants age 55 and older obtained by combining two independent mTurk data collections of adults in the United States. Results: In the current sample, duration of nightmares was associated with suicide risk in older adults independent of symptoms of current insomnia and nightmares, duration of insomnia, and symptoms of PTSD, anhedonia, and the IPTS. Conclusions: Our fi ndings suggest that the duration of nightmares (i.e., how long someone has been experiencing nightmares) predict substantial variance in suicide risk among older adults in addition to the risk factors typically examined. S uicide is a leading cause of death, yet it remains a challenge to predict and prevent. In 2012, suicide was the tenth leading cause of death in the United States, accounting for 40,600 deaths.1 Further, 2012 marks the fi rst time in history that U.S. deaths by suicide have exceeded 40,000 in a year.2 Suicide is a particularly large problem for older adults: although older adults only made up about 13.7% of the population in 2012, older adults represented 16.4% of suicides.1 Suicidal intent, which refers to the degree to which one desires to end his/her life by suicidal behavior, 3 is more common in older adults than in the rest of the population, and attempts made by older adults are more likely to be fatal. 4 To illustrate this, there are 100-200 attempts for every one youth suicide and 4 attempts for every one older adult suicide.5 Thus, older adult suicide attempts are much more likely to be fatal than younger adult suicide attempts. Research has identifi ed many risk factors for older adult suicide including the loss of independence, social isolation, mental illness, and decline in physical health. 4,[6][7][8] However, despite having identifi ed these risk factors, clinicians are still very po...

Examining the role of psychological factors in the relationship between sleep problems and suicide

“…Collectively, findings from these studies indicated that sleep problems were related to suicidality, independent of acquired capability for suicide (Golding et al, 2015, Nadorff et al, 2014). Hochard et al (2016) proposed alternative hypotheses whereby acquired capability was posited to interact with both severity of insomnia symptoms and the frequency and intensity of nightmares, to predict suicidal thoughts.…”

“…2; Chu et al, 2016, Golding et al, 2015, Littlewood et al, 2016, Nadorff et al, 2014). This is in agreement with findings from the broader literature.…”

Thwarted belongingness as an explanatory link between insomnia symptoms and suicidal ideation: Findings from three samples of military service members and veterans

“…These findings suggest that interpersonal theory constructs, including thwarted belongingness, may serve as an explanatory link between insomnia and suicide risk. Consistent with this assertion, a study of older adults also revealed that insomnia symptoms were no longer related to suicide risk after controlling for interpersonal theory variables (Golding et al, 2015). However, these equivocal results emphasize the need for further investigation into the relationship between these symptom constellations.…”

Poor sleep quality and suicide attempt among adults with internet addiction: A nationwide community sample of Korea

“…An association between sleep problems and suicidal behaviors has been widely documented [17–19]. But systematic analyses of insomnia and suicide-related thoughts and behaviors are still inconsistent across studies and there is a lack of empirical studies focusing on mediating factors in the insomnia and suicide relationship [20].…”