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Suicide attempters who suffer nightmares more likely to try again

February 4, 2009 |  1:23 pm

Suicide, the 11th most common cause of death in the United States, claimed the lives of more than 32,000 Americans in 2004 (the last year for which statistics are available). For every suicide carried out, there are an estimated eight to 25 suicide attempts.

Which of those who attempt suicide will try again? From Sweden's Gothenburg University comes one possible indicator: nightmares.

In a study following 98 patients who had attempted suicide and were hospitalized afterward, a doctoral candidate in Gothenburg's Institute of Neuroscience and Physiology found that those who complained of nightmares in the first week after their attempt were three times more likely than those who did not have nightmares to try again to commit suicide in the next two years. Those who continued to suffer from nightmares two months after trying to take their lives -- a group that represented about a third of those studied -- were at five times the risk of a repeat attempt over two years of follow-up.

The heightened probability of a repeat attempt among those suffering nightmares was seen in both men and women and did not vary with the severity of the patient's psychiatric symptoms or diagnosis, said the researcher, Nils Sjostrom.

In all, 28 of the 98 suicide attempters who participated in the study tried again in the two years after the attempt for which they were hospitalized. Sjostrom, a registered nurse, said that discerning what factors predict a repeat attempt is important, and noted that attentive hospital staff can help provide early warning and intervention for those at greater risk.

Sleep disturbances were very common among those who had attempted suicide -- 89% reported problems, including the inability to fall asleep, to stay asleep or problems with early-morning waking.  But only nightmares were associated with a higher rate of repeat suicide attempts. In all, 46% of those who attempted suicide again in the next two years had reported nightmares; among those who made no further suicide attempt in the next two years, 10% had reported suffering nightmares.

About 5% of the general population complain they have frequent nightmares, which take place during deep sleep in the second half of the sleep cycle and typically wake the sleeper completely. Women and those with depression are slightly more likely to suffer from these nocturnal terrors. In a 2004 study, adolescents who complain of frequent nightmares were found to be three times more likely to attempt suicide than adolescents who did not suffer have this frightening sleep disturbance.

Thinking about suicide, or know someone who is? Go here, or call (800) 273-TALK (8255) or (888) 628-9454 (para Espanol). Or, if you're interested in learning more about suicide prevention and your community, check this video out. To learn more about nightmares and what to do about them, check this site out. Not sure if they're nightmares or just bad dreams? This should explain it.   

-- Melissa Healy 

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