Trial reportSleep medicine2010
Insomnia severity is an indicator of suicidal ideation during a depression clinical trial.
Trial report in Sleep medicine, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 98 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
98 citing papers in PubMed, 4 syntheses or guidelines pooled it, 233 citations in OpenAlex.
- Systematic review and meta-analysis of the relationship between sleep disorders and suicidal behaviour in patients with depression.BMC psychiatry · 2019Pooled it
- Eszopiclone for insomnia.The Cochrane database of systematic reviews · 2018Pooled it
- Pharmacotherapy Treatment Options for Insomnia: A Primer for Clinicians.International journal of molecular sciences · 2015Guideline
- Sleep disturbances as an evidence-based suicide risk factor.Current psychiatry reports · 2015Pooled it
- Trial
- Reducing Suicidal Ideation Through Insomnia Treatment (REST-IT): A Randomized Clinical Trial.The American journal of psychiatry · 2019Trial
- Depression prevention via digital cognitive behavioral therapy for insomnia: a randomized controlled trial.Sleep · 2019Trial
- Efficacy of digital CBT for insomnia to reduce depression across demographic groups: a randomized trial.Psychological medicine · 2019Trial
- Relationships between temperaments, occupational stress, and insomnia among Japanese workers.PloS one · 2017Trial
- The Effects of Lithium Carbonate Supplemented with Nitrazepam on Sleep Disturbance during Cannabis Abstinence.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2015Trial
- A multi-site randomized clinical trial to reduce suicidal ideation in suicidal adult outpatients with Major Depressive Disorder: Development of a methodology to enhance safety.Clinical trials (London, England) · 2015Trial
- Pre-treatment insomnia as a predictor of single and combination antidepressant outcomes: a CO-MED report.Journal of affective disorders · 2015Trial
- Subjective and objective sleep and self-harm behaviors in young children: a general population study.Psychiatry research · 2013Trial
- SSRI versus bupropion effects on symptom clusters in suicidal depression: post hoc analysis of a randomized clinical trial.The Journal of clinical psychiatry · 2013Trial
- The Relationship of Early Sleep Improvement With Response to Pharmacotherapy in Unipolar Psychotic Depression.Journal of clinical psychopharmacologyTrial
- Nighttime Sensory-Behavioral Activation and Admission Suicidality in Young Inpatients With Major Depressive Disorder: A Retrospective Clinical-Record Study.Suicide & life-threatening behavior · 2026Article
- The effect of psychotherapy on the multivariate association between insomnia and depressive symptoms in late-life depression.European psychiatry : the journal of the Association of European Psychiatrists · 2025Article
- Association of insomnia with suicide attempts in Chinese chronic schizophrenia patients with and without autistic symptoms.BMC psychiatry · 2025Article
- Electroconvulsive therapy modulates the interplay between depressive symptoms in difficult-to-treat depression: A longitudinal network analysis.European psychiatry : the journal of the Association of European Psychiatrists · 2025Article
- The Association between Suicidal Ideation and Subtypes of Comorbid Insomnia Disorder in Apneic Individuals.Journal of clinical medicine · 2024Article
38 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
objectiveInsomnia has been linked to suicidal ideas and suicide death in cross-sectional and longitudinal population-based studies. A link between insomnia and suicide has not been previously examined in the setting of a clinical trial. Herein we describe the relationship between insomnia and suicidal thinking during the course of a clinical trial for depression with insomnia.
methodsSixty patients aged 41.5±12.5 years (2/3 women) with major depressive episode and symptoms of insomnia received open-label fluoxetine for 9 weeks and also received blinded, randomized eszopiclone 3mg or placebo at bedtime after the first week of fluoxetine. Insomnia symptoms were assessed with the Insomnia Severity Index (ISI), and suicidal ideation was assessed with The Scale for Suicide Ideation (SSI). Depression symptoms were assessed with the depressed mood item and the anhedonia item from the Hamilton Rating Scale for Depression-24 (HRSD24), as well as a sum score for all non-sleep and non-suicide items from the HRSD (HRSD20). Measurements were taken at baseline and weeks 1, 2, 4, 6, and 8. SSI was examined by generalized linear mixed models for repeated measures as the outcome of interest for all 60 participants with ISI and various mood symptoms as independent variables, with adjustment for age, gender, treatment assignment, and baseline SSI.
resultsHigher levels of insomnia corresponded to significantly greater intensity of suicidal thinking (p<0.01). The depressed mood item of the HRSD, and the sum of the HRSD20, both corresponded to greater suicidal thinking (p<0.001). The anhedonia item did not correspond with suicidal thinking. When both ISI and the depressed mood item, or ISI and the anhedonia item, were included together in the same model, the ISI remained an independent predictor of suicidal thinking.
conclusionsThe results support the concept that insomnia may be a useful indicator for suicidal ideation and now extend this idea into clinical trials. Insomnia remains an independent indicator of suicidal ideation, even taking into account the core symptoms of depression such as depressed mood and anhedonia. The complaint of insomnia during a depression clinical trial might indicate that more direct questioning about suicide is warranted.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.