Insomnia is a driver of suicide, and people with severe insomnia may safely benefit from taking a sedative to help address their sleep problems as it reduces their suicidal thoughts, a new study suggests.
The study, published in The American Journal of Psychiatry, included 103 participants aged 18 to 65 with major depressive disorder, insomnia and suicidal thoughts.
All participants took an antidepressant for the eight-week duration of the trial and half also took the sedative-hypnotic zolpidem at bedtime.
"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 co-presciption of a hypnotic during initiation of an antidepressant may be beneficial in suicidal outpatients, especially in patients with severe insomnia," said study researchers from Augusta University in the US.
During the study, 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.
Researchers also measured distorted thoughts about sleep, like participants thinking they would never again have a good night's sleep.
The frequency and intensity of disturbing dreams or nightmares, also a factor in insomnia-associated suicide, also were measured.
Patients wore a wrist device to keep up with rest/activity cycles.
Those taking the sleep aid showed both significant immediate and longer-term improvement in their reported insomnia severity.
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 sleep aid was most effective in reducing suicidal thoughts in patients with the most severe insomnia.
There were no deaths or suicide attempts by participants during the course of the study.
Two weeks after the study concluded both study groups -- including those not taking the sleep aid -- appeared to have maintained progress with reduced depression scores and suicidal thoughts.
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