Poor sleep tied to higher suicide risk in elders

Image by Alex via flickr.

Image by Alex via flickr.

The recent suicide of actor/comedian Robin Williams has put a spotlight on suicide and depression. However, older adults who suffer from sleep problems are at even greater risk of suicide, according to a recent study published in JAMA Psychiatry.

Researchers investigated the relative independent risk for suicide associated with poor subjective sleep quality in a population-based study of 14,456 community-dwelling older adults (age 65+) during a 10-year observation period. They compared the sleep quality of 20 suicide victims with the sleep quality of 400 similar individuals during that time. Participants with dysfunctional sleeping patterns had a 1.4 times greater chance of death by suicide than well-rested people.

Even after adjusting for depressive symptoms, they concluded that poor subjective sleep quality appears to present “considerable risk” for severe suicidal behaviors 10 years later.  Risk increases among patients with multiple illnesses.

“This is important because sleep disturbances are highly treatable, yet arguably less stigmatizing than many other suicide risk factors,” lead author lead author Rebecca Bernert, Ph.D., an instructor of psychiatry and behavioral sciences and director of the Suicide Prevention Research Laboratory at Stanford University said in a statement.

When comparing poor sleep and depression as independent risk factors, sleep disturbances were a greater predictor of suicide than depression. The combination of the two increased risk dramatically, according to the study.

These findings mesh with previous research on the association between sleep disorders and suicide risk.

Suicide is a major health problem, ranking as the 11th leading cause of death in the United States and accounting for about 30,000 deaths each year. There were an estimated 8,618 suicides among older adults in 2010, according to the Administration on Aging, or about 14.9/100,000, as reported in this New York Times article. Incidence is particularly high among older, white men (30.3/100,000).

The burden of chronic disease, social isolation, loss of a loved one, and other factors have been suggested as independent risk factors for suicide. The American Foundation for Suicide Research has a good breakdown of suicide rates in 2011 (most current data available) by age, gender, race, and region.

Bernert noted that the study results present an important opportunity for physician and family intervention and suicide prevention efforts. Older adults are known to visit their primary provider in the weeks and months prior to taking their own lives. Additionally, family and friends may already be aware of ongoing sleep disturbances. This may present a unique opportunity for risk detection.

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