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Reducing Suicide Risk through Insomnia Treatment

Suicide is the third- leading cause of death in people under age 30. Unmodifable risk factors include advancing age, male gender, and Caucasian ethnicity, whereas modifiable risk factors include symptoms of depression, hopelessness, social isolation, active alcohol/substance use, and severe sleep disturbance. An analysis of 32 studies found that sleep disturbance is associated with suicidal ideation or completed suicide. The relationship between sleep disturbance/insomnia and suicidality was not limited to those with MDD but was also applicable to the general population. However, insomnia is generally overlooked as a suicide risk factor. To study the effects of insomnia therapy on suicdality, it is important to find possible mediator between sleep disturbance and suicidal behavior. Preliminary data showed that hopelessness could mediate some of the effects of insomnia therapy on suicidality. Additional reasons to study the effects of insomnia therapy on suicidality: first, although the efficacy of sleep medicine interventions for insomnia is well-established, recent evidence suggests that their use may be a more important risk factor for suicidal behaviors than insomnia itself. Second, first-line drugs for depression may inhibit sleep, which may increase suicide risks.


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