The association between insomnia and suicidal thoughts in adults treated for alcohol dependence in Poland

Background: Suicidal ideation is elevated for individuals with alcohol use disorders. Sleep problems are associated with suicide risk and alcohol use, and sleep problems may be associated with suicide risk in those with alcohol use disorders. For the present study, we hypothesized that self-reported sleep problems are associated with suicidal thoughts in a sample of adults seeking treatment for alcohol dependence in Poland.

Methods: The sample included 304 patients in addiction treatment programs in Warsaw, Poland who met criteria for alcohol dependence. Measures included demographic characteristics, frequency of alcohol use, psychiatric symptoms, suicidal ideation and two measures of insomnia, which differed by time frame: the Athens Insomnia Scale (AIS, past 1 month) and the Sleep Disorders Questionnaire (SDQ-7, past 6 months). Multivariable logistic regression models tested the association between insomnia and suicidal thoughts.

Results: In models that controlled for age, gender, and days of recent drinking, both measures of sleep problems were associated with suicidal ideation: AOR=2.01 (95% CI: 1.50-2.70) [AIS] and 1.73 (95% CI: 1.29-2.31) [SDQ-7]. The association of sleep problems, as measured by the AIS, with suicide remained significant after adjusting for psychiatric symptoms, although the estimated effect size was smaller (AOR=1.47; 95% CI: 1.05-2.06).

Conclusions: Among Polish adults with alcohol dependence, insomnia severity was associated with suicidal ideation. This finding highlights the need to assess for sleep problems, in addition to suicidal thoughts, in alcohol treatment settings and to further examine the potential consequences of poor sleep in this population.