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A Good Night's Sleep Can Be a Matter of Life and Death

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There is no shortage of scientific studies being released on a regular basis showing links between obstructive sleep apnea (OSA), insomnia and other sleep disorders, and myriad negative health conditions, from daytime sleepiness to increased depression.

Now there is a new study showing a link between insomnia, the loss of hope, and an increased risk of suicide. In a study led by Dr. W. Vaughn McCall, chair of the Medical College of Georgia at Georgia Regents University, researchers studied the mental state of 50 depressed patients between the ages of 20 and 80. More than half of the patients had attempted suicide, and most were taking an antidepressant.

It is established that insomnia and nightmares often go hand-in-hand, and are both known risk factors for suicide. The new study reaffirms that link, but researchers also wanted to find out what effect feelings of hopelessness about sleep had on suicide risk.

In the study, the researchers specifically focused on the relationship between insomnia and suicide risk by asking questions about dysfunctional beliefs about sleep, such as, "Do you think you will ever sleep again?" The scientists used psychometric testing to objectively measure the mental states and personalities of the 50 depressed patients.

Dr. McCall published the results of the study in the Journal of Clinical Sleep Medicine from the American Academy of Sleep Medicine. In the report, Dr. McCall stated, "It turns out insomnia can lead to a very specific type of hopelessness, and hopelessness by itself is a powerful predictor of suicide." The study also noted that "the likelihood of being suicidal at least doubles when insomnia is a symptom."

McCall and his colleagues have, in effect, discovered a new predictor for suicidal thinking. But why the link between lack of sleep and suicidal thoughts? Dr. McCall explained, "It turns out insomnia can lead to a very specific type of hopelessness, and hopelessness by itself is a powerful predictor of suicide." He also said:

If you talk with depressed people, they really feel like they have failed at so many things. It goes something like, "My marriage is a mess, I hate my job, I can't communicate with my kids, I can't even sleep." There is a sense of failure and hopelessness that now runs from top to bottom, and [insomnia] is one more thing ... It was this dysfunctional thinking -- all these negative thoughts about sleep -- that was the mediating factor that explained why insomnia was linked to suicide.

The significance of this study, like many others, is that it not only educates people about the risks associated with insomnia and other sleep disorders, but it also challenges the medical community to look at things a little differently when diagnosing and treating.

In this case, the importance of examining lack of sleep and insomnia when treating depression and suicidal thinking. The finding also is a reminder to physicians that depressed patients who report increased sleep problems should be asked if they are having suicidal thoughts, McCall said.

If you're having trouble sleeping, here are some tips to increase your chances of getting a good night's sleep.

  • Use the bedroom for sleep. With so many electronic distractions in our lives, it's important to re-claim your bedroom for its intended purpose: rest and sleep. Move the TV and computer out of the bedroom, or at the very least, do not watch TV, work on the computer or check your Blackberry close to bedtime.

  • Stick to a bedtime routine. Try to go to sleep before 10:00 p.m. at night, and wake up around the same time every day, even on weekends. Try to keep to within 20 minutes of the same time each morning and night.
  • Do activities that will get you ready for bed. Before bed, do activities that will promote sleepiness, such as a taking a warm bath, or reading a book or magazine.
  • Maintain a cool temperature in your bedroom. A cool but comfortable temperature is ideal for sleep. Too warm and you will be fitful, too cold, however, can be uncomfortable and disturb your sleep.
  • Exercise regularly but not after the late afternoon. Even though exercise helps regulate sleep, rigorous exercise causes endorphins in the body to circulate, which can have a stimulant effect, and keep you awake longer at night.
  • Stay away from caffeine at night. The effects of caffeine are different from person to person, and may last hours after your last cup of coffee, so make your last cup of coffee, regular tea or soda earlier in the day.
  • Avoid alcohol and medicines that make you drowsy. Even if you think it is helping you fall asleep initially, alcohol and medicines that make you drowsy may affect your sleep throughout the night.
  • Remember, people need an average of seven to eight hours of restful sleep to fully take advantage of its restorative power and avoid daytime symptoms of fatigue. If a regular, peaceful routine incorporating the tips above doesn't help you start sleeping peacefully throughout the night, contact your doctor. You may have a more serious cause of sleeplessness such as snoring, sleep apnea or chronic insomnia. Getting treated could prevent heart disease, hypertension and stroke.

    For more by David Volpi, M.D., PC, FACS, click here.

    For more on sleep, click here.

    Need help? In the U.S., call 1-800-273-8255 for the National Suicide Prevention Lifeline.