Insomnia, Hyperarousal, and Suicide in Psychosis-Presentation Slides

Presentation Slides
Pdf Summary
This document is a summary of a presentation on the association between insomnia, hyperarousal, and suicide in psychosis. The presentation was part of an APA and SAMHSA initiative called the Clinical Support System for Serious Mental Illness (CSS-SMI). The document includes information on the faculty involved in the initiative and their disclosures.<br /><br />The presentation highlights several studies that explore the link between insomnia and suicide in individuals with psychotic disorders. A meta-analysis found that patients with psychiatric diagnoses and sleep disturbances, including insomnia, are significantly more likely to report suicidal behaviors. Various longitudinal studies also found that insomnia is a significant predictor of suicidal ideation and suicide attempt.<br /><br />The document provides details on specific studies conducted on patients with psychosis. These studies found that both insomnia and suicide are common phenomena in this population. One study found that baseline moderate-severe insomnia was associated with an increased risk of suicidal ideation. Another study examined the effects of clozapine, a medication used to treat psychosis, on insomnia and suicidal ideation and found that the resolution of insomnia was associated with a decreased risk of suicidal ideation.<br /><br />The presentation also discusses the evaluation and treatment of insomnia in individuals with psychosis. It highlights the importance of subjective and objective assessments of sleep and suggests psychoeducation on good sleep hygiene as a first step in treatment. Various pharmacologic and non-pharmacologic treatments, including sedating antipsychotics and cognitive-behavioral therapy for insomnia (CBT-I), are mentioned as potential options.<br /><br />Additionally, the presentation introduces the concept of hyperarousal as a potential mediator of the association between insomnia and suicide. The pupillary light reflex (PLR) is suggested as a practical measure of physiological arousal that could aid in assessing suicide risk.<br /><br />The presentation concludes by emphasizing the need for further research in this area and thanking the audience for their participation.
Keywords
insomnia
hyperarousal
suicide
psychosis
sleep disturbances
suicidal behaviors
suicidal ideation
clozapine
evaluation
treatment