The Connection Between Sleep Disturbance and Suicide
Trigger warning: This article discusses suicide. If you or a loved one are experiencing suicidal thoughts, there are resources available for support including the National Suicide Prevention Lifeline (1-800-273-8255) and online chat.
Suicide and sleep. This is a touchy and delicate subject but one that is very close to my heart. Because I have had issues with both.
There is a well-established connection between psychiatric illness and sleep disturbance and this connection can work both ways. Too much or too little sleep can be a result of mental illness or it can lead to a reduction in mental wellness.1
Conditions such as depression, anxiety, bipolar disorder, or schizophrenia are all known to have correlations between insomnia (too little sleep) and/or hyposomnia (too much sleep). While sleeping too much and/or too little can be a catalyst for mental illness.2
Suicide is at the pointy end of mental illness.
Suicide and sleep disturbance
According to the World Health Organization, almost 800,000 people die globally each year as a result of suicide. It is suggested there is 20 times that number of suicide attempts. That’s 16 million people around the world struggling with suicidality.3
There are a great many factors that contribute to a person making the decision to take their own life but there is growing research that sleep disturbance is one of these issues.4
My lifelong struggle with sleep
When my insomnia escalated to critical levels in March last year, I became one of those statistics. I have struggled with sleep since I was a wee tot. It has taken me a long time to distinguish my insomnia from restless legs syndrome (RLS). I believed if I could get the RLS controlled everything would be fine.
Eventually, the RLS was well controlled but still, my sleep was sporadic. It was better but not good. As my fortieth birthday slipped by and my fiftieth birthday stared me in the eye, things started to get out of control. Poor sleep turned to worse sleep. Sleepless nights turned to sleepless weeks. A couple of hours here and there turned to a few minutes here and there.
I nearly lost my life
Then I lost my mind. I was diagnosed with depression and anxiety in 2016 and treated accordingly. But nothing helped my sleep. Roll on 2020 and everything tumbled into a heap. I nearly lost my life.
During my 2-month hospital admission, my inability to sleep was the number one item to figure out. If I couldn’t sleep, all the psychological interventions in the world were never going to help.
It took several weeks and a lot of experimentation but eventually the treating team found pharmacological solutions for my extreme insomnia. By the time I left the clinic, I was consistently sleeping 6 to 8 hours per night, and that sleep has changed my life.
Studies on the link between sleep disturbance and suicidiality
Over 60 studies have demonstrated a link between sleep disturbance and suicidality, and numerous theories articulate the different possibilities for this connection.4,5
- Chronic sleep deprivation could cause sufficient psychological distress to bring on periods of suicidal ideation
- Sleep deprivation could possibly desensitize brain serotonin receptors which is a factor in suicide
- Chronic physiological and/or psychological illness - including sleep disorders - is a known contributor to suicide risk
- Cognitive function is impaired with sleep disturbance and reduced problem-solving ability is associated with suicide
- Living with insomnia has been linked to an increased sense of hopelessness which is also a symptom of suicidal ideation
- Hypervigilance and hyperarousal are linked to suicidality and both, in turn, can increase sleep disturbance
There are also studies looking at sleep as being an independent risk factor for suicide. Meaning that even when depression or other comorbidities are accounted for, sleep disturbance alone can be a risk factor. These are preliminary studies and are not - to my inexpert eyes - definitive.
But I can say from anecdotal experience, critically low sleep - or for the most part, no sleep - over an extended period of time caused me to lose my mind. I lost weeks and weeks of my life when I was sleeping barely 20 minutes every other night.
Reaching out and seeking support
With a team of specialists coordinating to improve both my mental health and sleep simultaneously, I have come through. Now when I have a bad night it is still 4 to 5 hours sleep - which is enough for me to maintain a certain level of sanity.
Suicidality is a difficult topic to talk about but I would encourage anyone concerned for themselves or for someone else, to reach out and seek support. And if you’re not sleeping well, add that to the list of things you chat to the doctor about. Sleep might just save your life.
Do you have any perfectionistic tendencies?