Background: Many people who struggle with suicidality also suffer from sleep problems (Dong et al., 2021). Recent findings suggest that psychotherapeutic sleep interventions may have a positive effect on suicidality (McCall et al., 2019). On the other hand, there are indications that certain sleeping pills (e.g., zolpidem) appear to be associated with an increased risk for suicidality (Khan et al., 2022). These findings highlight the need for a systematic examination of the effect of both pharmacological and non-pharmacological sleep interventions on suicidality.
Aim: We examine the effect of pharmacological and non- pharmacological sleeping interventions on suicidal thoughts and behavior.
Methods: In accordance with PRISMA guidelines, a systematic literature search of various scientific databases was conducted. RCTs that examined the effect of sleep interventions on suicide-related outcomes were searched.
Results: The search strategy resulted in 4,173 unique articles. A total of 37 articles were included in the systematic review (n=12 examined suicidality as a primary/secondary outcome; n=25 included suicidality as an adverse outcome). Preliminary findings suggest that sleep interventions have a small positive effect on reducing suicidality. Data extraction and risk-of-bias assessment of the adverse-outcome studies are currently underway. Finalized results are expected in April 2024.
Conclusion: The results will be interpreted on the basis of empirical findings and existing models on the relationship between sleep and suicidality. In consultation with clinicians and lived experience experts, recommendations are formulated for clinical practice, which will be implemented in the Dutch Suicide Prevention Toolkit for mental health professionals (https://www.113.nl/voor-professionals/suicidepreventie-sector/de-suicidepreventie-toolkit-voor-de-ggz).
References:
Dong et al (2021). Sleep Disturbances and the Risk of Incident Suicidality: A Systematic Review and Meta-Analysis of Cohort Studies. Psychosomatic medicine
Khan et al (2022). Zolpidem use and risk of suicide: A systematic review and meta-analysis. Psychiatry research
McCall et al (2019). Reducing Suicidal Ideation Through Insomnia Treatment (REST-IT): A Randomized Clinical Trial. The American journal of psychiatry