Nightmares increase risk of further suicide attempts

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A thesis from the Sahlgrenska Academy, University of Gothenburg, Sweden, concludes that people who have nightmares following a suicide attempt are five times more likely to attempt suicide again, compared with those who do not have nightmares.

The study included 165 patients aged 18-69 years, who were being treated at somatic and psychiatric departments following a suicide attempt in Sweden. Psychiatric interviews and self-assessments were carried out as part of the study during the week following the suicide attempt, and then two months later. Ninety-eight people attended the follow-up interview.

The study shows that those patients who complained of nightmares during the week following the suicide attempt were three times more likely to attempt to take their own life again, regardless of gender or psychiatric diagnosis, such as depression or post-traumatic stress syndrome.

"Those who were still suffering from nightmares after two months faced an even greater risk. These people were five times more likely to attempt suicide a second time,” says author of the thesis, Registered Nurse Nils Sjöström.

Other sleeping difficulties do not increase risk of repeat suicide attempts

It is normal for patients that have attempted suicide to suffer from sleeping difficulties. Some 89 percent of the patients examined reported some kind of sleep disturbance. The most common problems were difficulty initiating sleep, followed by difficulty maintaining sleep, nightmares and early morning awakening. Nils Sjöström has also examined the possibility of there being an increased risk of repeat suicide attempts if the patient has difficulty falling asleep, difficulty sleeping during the night, or wakes up early in the morning. However, the result did not indicate any increased risk.

“The results show how important it is for healthcare staff to highlight the significance of nightmares in the clinical suicide risk assessment,” says Nils Sjöström.

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The thesis was written by: Registered Nurse Nils Sjöström, tel: +46 (0)31 3422163, mobile: +46 (0)70 7437110, e-mail:

Supervisor: Associate Professor Margda Waern, tel: +46 (0)31 3422164, e-mail:
Professor Jerker Hetta, tel: +46 (0)8 58586871, e-mail:

Thesis for the degree of Doctor of Medicine at the Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden.

Title of thesis: Sleep, sense of coherence and suicidality in suicide attempters

Contact: Nils Sjostrom

46-070-743-7110
University of Gothenburg

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