Sleep problems, nightmares linked to suicide and mental illness

Psych Central today reported on several papers presented at SLEEP 2009, a Seattle conference of sleep researchers organized by The Associated Professional Sleep Societies. Together, the data suggest that problems with sleep, including insomnia and nightmares, are linked to anxiety, depression, and suicide risk. Dr. Philip Gehrman of the University of Pennsylvania examined data from hundreds of identical and fraternal twins. Although twins overall did not show increased rates of insomnia, if one twin was having trouble sleeping, their identical twin was more likely to have insomnia as well. This pattern was not observed among fraternal twins. Psych Central reported that the genetic component of insomnia overlapped significantly with gene effects related to depression and anxiety. At least part of this overlap is probably related to the symptoms used to diagnose mood and anxiety disorders, both of which include sleep disturbances as diagnostic criteria.

In a related study, researchers looked at nightmares in addition to mood and sleep problems. In a group of patients reporting to a community mental health hospital awaiting an emergency evaluation, insomnia alone was not linked to suicide risk. However, patients who reported severe nightmares were more likely to report thoughts of suicide as well - even after depressive symptoms were statistically controlled.

A third study was more specific to teens. James Gangwisch of Columbia University and his colleagues examined information collected about over 15,000 adolescents in a National Institute of Health study. They found that teens whose parents set their bedtimes at midnight or later were 25% more likely to report depressive symptoms and 20% more likely to report suicidal thoughts than those who went to bed at 10:00 or earlier. Although many other factors could account for the link between late bedtimes, depression, and thoughts of suicide (for example, there might be other differences between parents who allow their teens to stay up past midnight and those who don't), previous research - including the other studies described above - suggests that a legitimate connection exists between sleep and mental illness.

To my knowledge, none of these studies examined whether addressing sleep problems will result in a reduction in other symptoms. However, few would disagree that a good night's sleep can have a positive effect on mood, and we've reported previously at Family Anatomy that academic performance can also be affected by disturbances in sleep. Can parents have an impact on their children's sleep patterns? Hopefully! Education may be helpful - parents who share information with their teens about the possible impact of sleep problems might motivate their kids to make some changes. Honestly, I can't think of too many insomniacs who wouldn't appreciate getting a good night's sleep!

Some information that might be helpful:

• Caffeine, nicotine, and alcohol disrupt sleep, and might have an effect on sleep even when taken earlier in the day. Try to limit these substances in the afternoon and evening.
• Computer games and television can be stimulating, too. Some parents might recall that even a long Tetris session can result in thoughts of falling shapes when you're trying to drift off! Limit video games, computer time and television in the hours before bed if your children are having trouble sleeping.
• Mentally and physically stimulating activities (exercise, studying) just before bed can interfere with sleep.
• Consistent sleep and waking times can be important; stable routines can get your brain and body into the habit of slowing down at bedtime. Another habit that can get in the way is studying, doing homework, reading, or watching TV in bed. If your bed is reserved for sleep only, your mind and body will be cued that it's time to sleep when you go to bed.
• Eliminate napping - even if your teen is tired during the day, napping in the afternoon can interfere with sleep at night!

You can read about Dr. Gehrman's genetic research here. The nightmare study is described here. The teen bedtime study is discussed here.

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Note: Posts on Family Anatomy are for education only. If you need to talk to someone about family or mental health issues, you can get a referral from your family doctor.