Afterward their condition remained the same or continued to improve, McCall says. To address these concerns, participants only received a week's supply of the sleep aid until their suicidal thoughts began to abate, and the sleep aid was stopped after eight weeks. Hypnotics, like the drug they used for the study, are a common means to commit suicide, and there are also concerns about becoming dependent on them. Both lay the groundwork for doing additional outpatient trials for patients with suicidal thoughts, McCall says. The investigators note the safety of using narcotics in patients with suicidal thoughts and the fact that participants largely followed study protocols very well also were important findings. There were no deaths or suicide attempts by participants during the course of the study. The sleep aid was most effective in reducing suicidal thoughts in patients with the most severe insomnia. While both groups reported significant improvement in their feelings about hopelessness, quality of life, nightmares and dysfunctional beliefs about sleep, as well as related insomnia and suicidality, the group taking the sleep aid had a greater reduction in suicidal thinking, the investigators report. Those taking the sleep aid showed both significant immediate and longer-term improvement in their reported insomnia severity. Depression severity was measured by psychiatry staff at each study visit and participants also completed the Beck Hopelessness Scale, which measures pessimism and negative expectations and is considered a predictor of suicidal behavior in adults and adolescents. Patients wore a wrist device to keep up with rest/activity cycles. The frequency and intensity of disturbing dreams or nightmares, also a factor in insomnia-associated suicide, also were measured. Investigators also measured distorted thoughts about sleep, like participants thinking they would never again have a good night's sleep, something McCall has previously shown is itself a risk factor for suicide. Participants completed regular self-reports of the severity of their insomnia and completed a daily sleep diary during their treatment that included details like how many times they woke up during the night and how long they actually slept. Thirty percent had a prior suicide attempt, however individuals with an active and imminent plan to commit suicide were excluded out of concern for their safety since it was an outpatient study, McCall notes.Īll participants took an antidepressant for the eight-week duration of the trial and half also took the sedative-hypnotic zolpidem at bedtime. The study at MCG, Duke University and the University of Wisconsin included 103 participants ages 18 to 65 with major depressive disorder, insomnia and suicidal thoughts. "While the results do not argue for the routine prescription of hypnotics for mitigating suicidal ideation in all depressed outpatients with insomnia, they suggest that copresciption of a hypnotic during initiation of an antidepressant may be beneficial in suicidal outpatients, especially in patients with severe insomnia," the investigators write. He is hoping the REST-IT - Reducing Suicidal Ideation Through Insomnia Treatment - study, the first clinical trial looking at whether targeted insomnia treatment reduces suicide risk, will help change that. More than 30 studies have linked insomnia to suicidal thoughts or actions, however suicide risk and prevention are largely overlooked in the treatment of insomnia, says McCall, an expert in the trifecta of insomnia, depression and suicide. "If your patient says their sleep problem is really bad and they have had thoughts of killing themselves, maybe they should have a targeted treatment for their insomnia," says McCall, corresponding author of the study in The American Journal of Psychiatry. Vaughn McCall, chair of the Department of Psychiatry and Health Behavior at the Medical College of Georgia at Augusta University. Thank you for visiting my shop."If you have a patient who complains that their sleep has taken a turn for the worse then there is reason to open the door to a question about suicide," says Dr. Please keep in mind that colors might vary from monitor to monitor.įollow me on Instagram for previews, codes, and read my shop policies and FAQs before purchasing.Īll artwork is property of ©VaaleaTumma. Die-cutting method: Kiss-cut for easily removable from the sheet.Material: High quality professional matte sticker paper.Sheet size: 4圆 inches (10x15 cm) approx.Quantity stickers: 14 pcs (large - 2, medium - 4, small - 8).High-quality stickers for your Erin Condren Planner, Plum Paper Planner, Filofax, Midori, Kikki K, Happy Planner or whatever planners, bullet journals, calendars, organizers, scrapbook. Hand-drawn cute planner stickers "Ensi" - I Can't Sleep planner stickers
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