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Depression and the relationship between sleep disturbances, nightmares, and suicidal ideation in treatment-seeking Canadian Armed Forces members and veterans.
BMC Psychiatry. 2018 06 19; 18(1):204.BP

Abstract

BACKGROUND

Research on the relationship between insomnia and nightmares, and suicidal ideation (SI) has produced variable findings, especially with regard to military samples. This study investigates whether depression mediated the relationship between: 1) sleep disturbances and SI, and 2) trauma-related nightmares and SI, in a sample of treatment-seeking Canadian Armed Forces (CAF) personnel and veterans (N = 663).

METHOD

Regression analyses were used to investigate associations between sleep disturbances or trauma-related nightmares and SI while controlling for depressive symptom severity, posttraumatic stress disorder (PTSD) symptom severity, anxiety symptom severity, and alcohol use severity. Bootstrapped resampling analyses were used to investigate the mediating effect of depression.

RESULTS

Approximately two-thirds of the sample (68%; N = 400) endorsed sleep disturbances and 88% (N = 516) reported experiencing trauma-related nightmares. Although sleep disturbances and trauma-related nightmares were both significantly associated with SI on their own, these relationships were no longer significant when other psychiatric conditions were included in the models. Instead, depressive symptom severity emerged as the only variable significantly associated with SI in both equations. Bootstrap resampling analyses confirmed a significant mediating role of depression for sleep disturbances.

CONCLUSIONS

The findings suggest that sleep disturbances and trauma-related nightmares are associated with SI as a function of depressive symptoms in treatment-seeking CAF personnel and veterans. Treating depression in patients who present with sleep difficulties may subsequently help mitigate suicide risk.

Authors+Show Affiliations

Parkwood Institute Operational Stress Injury Clinic, London, ON, Canada. don.richardson@sjhc.london.on.ca. Department of Psychiatry, Western University, London, ON, Canada. don.richardson@sjhc.london.on.ca. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada. don.richardson@sjhc.london.on.ca.Parkwood Institute Operational Stress Injury Clinic, London, ON, Canada.Parkwood Institute Operational Stress Injury Clinic, London, ON, Canada.Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada. Anxiety Treatment and Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.Parkwood Institute Operational Stress Injury Clinic, London, ON, Canada. Department of Graduate Studies, Ryerson University, Toronto, ON, Canada.Parkwood Institute Operational Stress Injury Clinic, London, ON, Canada.Parkwood Institute Operational Stress Injury Clinic, London, ON, Canada. Department of Psychiatry, University of Toronto, Toronto, ON, Canada.Departments of Psychology and Psychiatry, University of Toledo, Toledo, OH, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29921268

Citation

Don Richardson, J, et al. "Depression and the Relationship Between Sleep Disturbances, Nightmares, and Suicidal Ideation in Treatment-seeking Canadian Armed Forces Members and Veterans." BMC Psychiatry, vol. 18, no. 1, 2018, p. 204.
Don Richardson J, King L, St Cyr K, et al. Depression and the relationship between sleep disturbances, nightmares, and suicidal ideation in treatment-seeking Canadian Armed Forces members and veterans. BMC Psychiatry. 2018;18(1):204.
Don Richardson, J., King, L., St Cyr, K., Shnaider, P., Roth, M. L., Ketcheson, F., Balderson, K., & Elhai, J. D. (2018). Depression and the relationship between sleep disturbances, nightmares, and suicidal ideation in treatment-seeking Canadian Armed Forces members and veterans. BMC Psychiatry, 18(1), 204. https://doi.org/10.1186/s12888-018-1782-z
Don Richardson J, et al. Depression and the Relationship Between Sleep Disturbances, Nightmares, and Suicidal Ideation in Treatment-seeking Canadian Armed Forces Members and Veterans. BMC Psychiatry. 2018 06 19;18(1):204. PubMed PMID: 29921268.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Depression and the relationship between sleep disturbances, nightmares, and suicidal ideation in treatment-seeking Canadian Armed Forces members and veterans. AU - Don Richardson,J, AU - King,Lisa, AU - St Cyr,Kate, AU - Shnaider,Philippe, AU - Roth,Maya L, AU - Ketcheson,Felicia, AU - Balderson,Ken, AU - Elhai,Jon D, Y1 - 2018/06/19/ PY - 2018/02/26/received PY - 2018/06/11/accepted PY - 2018/6/21/entrez PY - 2018/6/21/pubmed PY - 2019/4/23/medline KW - Canadian armed forces KW - Insomnia KW - Major depressive disorder KW - Nightmares KW - Posttraumatic stress disorder KW - Suicide SP - 204 EP - 204 JF - BMC psychiatry JO - BMC Psychiatry VL - 18 IS - 1 N2 - BACKGROUND: Research on the relationship between insomnia and nightmares, and suicidal ideation (SI) has produced variable findings, especially with regard to military samples. This study investigates whether depression mediated the relationship between: 1) sleep disturbances and SI, and 2) trauma-related nightmares and SI, in a sample of treatment-seeking Canadian Armed Forces (CAF) personnel and veterans (N = 663). METHOD: Regression analyses were used to investigate associations between sleep disturbances or trauma-related nightmares and SI while controlling for depressive symptom severity, posttraumatic stress disorder (PTSD) symptom severity, anxiety symptom severity, and alcohol use severity. Bootstrapped resampling analyses were used to investigate the mediating effect of depression. RESULTS: Approximately two-thirds of the sample (68%; N = 400) endorsed sleep disturbances and 88% (N = 516) reported experiencing trauma-related nightmares. Although sleep disturbances and trauma-related nightmares were both significantly associated with SI on their own, these relationships were no longer significant when other psychiatric conditions were included in the models. Instead, depressive symptom severity emerged as the only variable significantly associated with SI in both equations. Bootstrap resampling analyses confirmed a significant mediating role of depression for sleep disturbances. CONCLUSIONS: The findings suggest that sleep disturbances and trauma-related nightmares are associated with SI as a function of depressive symptoms in treatment-seeking CAF personnel and veterans. Treating depression in patients who present with sleep difficulties may subsequently help mitigate suicide risk. SN - 1471-244X UR - https://www.unboundmedicine.com/medline/citation/29921268/Depression_and_the_relationship_between_sleep_disturbances_nightmares_and_suicidal_ideation_in_treatment_seeking_Canadian_Armed_Forces_members_and_veterans_ L2 - https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-018-1782-z DB - PRIME DP - Unbound Medicine ER -