Insomnia and reducing suicide - the importance of sleep

The risk of suicide in people with insomnia could be reduced if they are able to get more sleep. 

Suicide is one of the major leading causes of death. Approximately 1 million people die each year worldwide from suicide. Suicidal behaviour is complex. Relevant risk factors vary with age, gender, and ethnic group and may even change over time. However, more than 90% of people who kill themselves have depression or another diagnosable mental or substance abuse disorder, often in combination with other mental disorders. Prior suicide attempt, family history of mental disorder or substance abuse, family history of suicide, family violence, including physical or sexual abuse, firearms in the home, incarceration and exposure to the suicidal behaviour of others are among the risk factors ( Agargun, M. Y., Lütfullah Beşiroğlu, 2005).

A very recent study found a relationship between sleep duration and suicidal thoughts in people with insomnia (Linden Oliver, University of Pennsylvania). Specifically, researchers discovered that every one-hour increase in sleep duration was associated with a 72 percent decrease in the likelihood of moderate or high suicide risk.

“We were surprised by the strength of the association between sleep duration and suicide risk,” said primary author Linden Oliver, M.A., clinical research coordinator for the University of Pennsylvania Behavioural Sleep Medicine Research Program.

“A 72 percent decrease in the likelihood of moderate or high suicide risk with a one-hour increase in sleep is interesting given the small sample size.”

Everyone’s individual sleep needs vary. In general, most healthy adults are built for 16 hours of wakefulness and need an average of eight hours of sleep a night. However, some individuals are able to function without sleepiness or drowsiness after as little as six hours of sleep. Others can't perform at their peak unless they've slept ten hours.

Earlier studies have also found that people with insomnia are up to twice as likely to commit suicide as people who don't have such difficulties sleeping. A 2011 study in teens found that those who had sleep problems at ages 12 to 14 were 2.5 times more likely to have suicidal thoughts in their late teen years.

Depending on the person, insomnia could be a cause or an effect of depression. Insomnia can lead to a very specific type of hopelessness, and hopelessness by itself is a powerful predictor of suicide ( Dr. W. Vaughn McCall).

Every cell in our bodies runs on a 24-hour clock, tuned to the night-day / light-dark cycles. It can be said that the brain acts as timekeeper, keeping the cellular clock in sync with the outside world so that it can govern our appetites, sleep, moods and much more. The research also shows that the clock may be broken in the brains of people with depression even at the level of the gene activity inside their brain cells (Proceedings of the National Academy of Sciences, the University of Michigan Medical School).

In a normal brain, the pattern of gene activity at a given time of the day is so distinctive that the authors could use it to accurately estimate the hour of death of the brain donor, suggesting that studying this "stopped clock" could conceivably be useful in forensics. By contrast, in severely depressed patients, the circadian clock was so disrupted that a patient's "day" pattern of gene activity could look like a "night" pattern and vice versa. 

Sleep is essential for a person’s health and well-being. Sleeping poorly increases the risk of poor mental health and physical health. As such, it is important to recognise the link between sleep and mental health and to highlight a dire need for people to begin to take sleep seriously as a health concern.