title: Sleep disturbances and suicidal ideation in a sample of treatment-seeking Canadian Forces members and veterans.
abstract: This study examines the association between suicidal ideation and sleep disturbances in a sample of treatment-seeking Canadian Forces members and veterans, after controlling for probable posttraumatic stress disorder (PTSD), major depressive disorder (MDD), generalised anxiety disorder (GAD), and alcohol use disorder (AUD). Subjects included members and veterans of Canadian Forces seeking treatment at a hospital-based Operational Stress Injury Clinic (n=404). Sleep disturbances and nightmares were measured using individual items on the PTSD Checklist - Military Version (PCL - M), while the suicidality item of the Patient Health Questionnaire (PHQ-9) was used as a stand-alone item to assess presence or absence of suicidal ideation. Regression analyses were used to determine the respective impact of (1) insomnia and (2) nightmares on suicidal ideation, while controlling for presence of probable PTSD, MDD, GAD, and AUD. We found that 86.9% of patients reported having problems falling or staying asleep and 67.9% of patients reported being bothered by nightmares related to military-specific traumatic events. Neither sleep disturbances nor nightmares significantly predicted suicidal ideation; instead, probable MDD emerged as the most significant predictor. The clinical implications of these findings and their potential impact on treatment guidelines are discussed.
authors.affiliation: Parkwood Hospital Operational Stress Injury Clinic, St. Joseph׳s Health Care London, London, Ontario, Canada; Department of Psychiatry, Western University, London, Ontario, Canada; Department of Psychiatry and Behavioral Neuroscience, McMaster University, Hamilton, Ontario, Canada. Electronic address: don.richardson@sjhc.london.on.ca.
authors.forename: J
authors.initials: J
authors.lastname: Don Richardson
authors.affiliation: Parkwood Hospital Operational Stress Injury Clinic, St. Joseph׳s Health Care London, London, Ontario, Canada.
authors.forename: Kate St
authors.initials: KS
authors.lastname: Cyr
authors.affiliation: Parkwood Hospital Operational Stress Injury Clinic, St. Joseph׳s Health Care London, London, Ontario, Canada; Department of Psychology, Western University, London, Ontario, Canada.
authors.forename: Charles
authors.initials: C
authors.lastname: Nelson
authors.affiliation: Department of Psychology, University of Toledo, Toleldo, OH, USA; Department of Psychiatry, University of Toledo, Toleldo, OH, USA.
authors.forename: Jon D
authors.initials: JD
authors.lastname: Elhai
authors.affiliation: Deer Lodge Operational Stress Injury Clinic, Winnipeg, Manitoba, Canada; Department of Psychiatry,University of Manitoba, Winnipeg, Manitoba, Canada; Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Jitender
authors.initials: J
authors.lastname: Sareen
mesh_terms: D000328:Adult; D002170:Canada; D003865:Major Depressive Disorder / Q000150:complications / Q000523:psychology; D004325:Dreams / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000523:psychology*; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology*; D012893:Sleep Wake Disorders / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000523:psychology; D059020:Suicidal Ideation; D013405:Suicide; D014728:Veterans / Q000523:psychology*
keywords: Depression; Military; Posttraumatic stress disorder; Sleep; Suicidal ideation