Insomnia Symptoms and Suicide-Related Ideation in U.S. Army Service Members

Background: Insomnia has been identified as a key risk factor for suicide, though most studies have been limited to global measures of these constructs. The aim of the present study was to evaluate the link between insomnia symptoms and five different aspects of suicide-related ideation. Participant...

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Bibliographic Details
Published in:	Behavioral sleep medicine Vol. 18; no. 6; pp. 820 - 836
Main Authors:	Vargas, Ivan, Perlis, Michael L., Grandner, Michael, Gencarelli, Amy, Khader, Waliuddin, Zandberg, Laura J., Klingaman, Elizabeth A., Goldschmied, Jennifer R., Gehrman, Philip R., Brown, Gregory K., Thase, Michael E.
Format:	Journal Article
Language:	English
Published:	England Taylor & Francis 01-11-2020 Taylor & Francis Ltd
Subjects:	Adult Clinical assessment Clinical significance Death & dying Delineation Female Humans Insomnia Male Military Personnel - psychology Retrospective Studies Risk Factors Servicemen Sleep Initiation and Maintenance Disorders - complications Sleep Initiation and Maintenance Disorders - psychology Subtypes Suicidal Ideation Suicide Suicides & suicide attempts United States United States United States > US
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Summary:	Background: Insomnia has been identified as a key risk factor for suicide, though most studies have been limited to global measures of these constructs. The aim of the present study was to evaluate the link between insomnia symptoms and five different aspects of suicide-related ideation. Participants: 1,160 active U.S. Army service members (719 male; M age = 31.2; SD age = 8.62). Methods: As part of an archival analysis, retrospectively assessed insomnia, depression, anxiety symptoms, as well as suicide-related ideation, were evaluated. Suicide-related ideation was assessed in terms of: thoughts of death, thoughts of suicide, suicidal plan, suicidal intent, and suicidal communication. Results: Subjects with clinically significant insomnia symptoms were 3.5 times more likely to report any suicide-related ideation, and approximately 3 times more likely to report thoughts of death and thoughts of suicide. More frequent nocturnal awakenings (i.e., waking up three or more times during a single night) were associated with a greater likelihood of reporting thoughts of death or suicide, whereas greater middle insomnia (i.e., waking up and having difficulty getting back to sleep) was associated with lower odds of experiencing thoughts of suicide, suicidal plan, and suicidal intent. Conclusions: A more refined delineation of insomnia and suicide-related ideation may serve to clarify the nature of the association, and potentially offer some clues as to the underlying mechanisms. With regard to potential clinical implications, the results support that careful assessment of insomnia symptoms, suicide-related ideation, and their respective subtypes, is important and may influence how we estimate risk for suicide.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1540-2002 1540-2010
DOI:	10.1080/15402002.2019.1693373