2 - (SYM 50) Sleep Disturbance Is Related to Ongoing Suicidal Ideation Among Adults with a Recent Suicide Attempt

Sleep disturbances are broadly associated with suicide risk. Greater insomnia severity and nightmares are each associated with suicidal ideation (SI) and suicide attempts, and a diagnosis of sleep apnea is associated with increased risk of a suicide attempt. However, little is known about how sleep disturbances are related to SI among those with a recent suicide attempt, a group at particularly high risk for a subsequent attempt. Clarifying this relation is important because sleep disturbances are modifiable, and thus may be a treatment target to reduce risk for future suicide attempts. We examined the relation between three forms of sleep disturbance and presence of current SI in a sample of adults with a recent suicide attempt. We hypothesized that more weekly nightmares, presence of suspected sleep apnea, and greater insomnia severity would each be associated with increased likelihood of current SI. This sample included baseline data from N = 326 adults (M age = 34.95, SD = 14.86) enrolled in a randomized controlled trial for a brief intervention for adults with a recent suicide attempt. Measures included the Insomnia Severity Index (total score), Behavioral Risk Factor Surveillance System (average number of nightmares/week, presence or absence of suspected sleep apnea [both snoring and pauses in breathing at night]), and Depressive Symptom Inventory Suicidality Subscale (total scores dichotomized to 0 = SI absent, 1+ = SI present). We covaried for age due to its association with suspected sleep apnea. At the bivariate level, current SI was associated with more weekly nightmares, greater insomnia severity, lack of suspected sleep apnea, and younger age; suspected sleep apnea was associated with older age. Using multiple logistic regression, only greater insomnia severity was significantly associated with increased likelihood of current SI. Findings suggest that among adults with a recent suicide attempt, those with greater insomnia severity, over and above other forms of sleep disturbance, are more likely to continue to experience SI. Sleep-related cognitions are modifiable within the context of CBT for Insomnia (CBT-I). Delivering CBT-I to patients with a variety of comorbid conditions has been shown to reduce symptoms of the comorbid condition and may increase engagement and/or adherence to other mental health treatment. Thus, for adults with a recent suicide attempt who report insomnia symptoms and ongoing SI, initiating CBT-I and continuing to address sleep-related cognitions throughout treatment may augment overall treatment outcomes.