Trial reportThe American journal of psychiatry2019
Reducing Suicidal Ideation Through Insomnia Treatment (REST-IT): A Randomized Clinical Trial.
Registry-linked trialOpen access · bronzeAbstract readRandomized Controlled Trial
In one paragraph
Trial report in The American journal of psychiatry, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04986007 (Addressing Nocturnal Sleep/Wake Effects on Risk of Suicide in Older Adults), which is not on this map. Cited by 68 papers, 4 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
68citing papers in PubMed, 4 pooled it
14.7field-weighted citation impact, top 1% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Addressing Nocturnal Sleep/Wake Effects on Risk of Suicide in Older Adults (ANSWERS-OA): A Pilot, Open-Label, Randomized Controlled Trial of Digital Cognitive Behavioral Therapy for Insomnia
Who cites it
68 citing papers in PubMed, 4 syntheses or guidelines pooled it, 149 citations in OpenAlex.
- A systematic review of anti-suicidal effects of sedative-hypnotics and cognitive behavioral therapy for insomnia.CNS spectrums · 2025Pooled it
- Efficacy and safety of each class of sleep medication for major depressive disorder with insomnia symptoms: A systematic review and meta-analysis of double-blind randomized controlled trials.Psychiatry and clinical neurosciences · 2025Pooled it
- Risk of Suicidal Behaviors and Antidepressant Exposure Among Children and Adolescents: A Meta-Analysis of Observational Studies.Frontiers in psychiatry · 2022Pooled it
- Psychosocial interventions for self-harm in adults.The Cochrane database of systematic reviews · 2021Pooled it
- Efficacy and safety of lemborexant in subjects with insomnia disorder receiving medications for depression or anxiety symptoms.Neuropsychopharmacology reports · 2025Trial
- Chronotherapeutic intervention targeting emotion regulation brain circuitry, symptoms, and suicide risk in adolescents and young adults with bipolar disorder: a pilot randomised trial.BMJ mental health · 2025Trial
- Trial
- Prevention of Incident and Recurrent Major Depression in Older Adults With Insomnia: A Randomized Clinical Trial.JAMA psychiatry · 2022Trial
- Irritability as an independent predictor of concurrent and future suicidal ideation in adults with stimulant use disorder: Findings from the STRIDE study.Journal of affective disorders · 2021Trial
- Association between irritability and suicidal ideation in three clinical trials of adults with major depressive disorder.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2020Trial
- Trial
- An exploratory analysis of the association of circadian rhythm dysregulation and insomnia with suicidal ideation over the course of treatment in individuals with depression, insomnia, and suicidal ideation.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2020Trial
- Suicide and Sleep Disorders: The Role of Insomnia, Nightmares, and Circadian Disruption.Cureus · 2026Review
- Synaptic Plasticity-Intrinsic Excitability and Antidepressant Discovery.Biomedicines · 2026Review
- Management of Insomnia Complaints by Non-Sleep Specialist Physicians: A French DELPHI Consensus.Journal of sleep research · 2026Article
- Mapping the genetic landscape of suicide risk: Insights from genomic SEM.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2026Article
- The effect and safety of sleep interventions on suicidal thoughts and behavior - A systematic review and meta-analyses.Sleep medicine: X · 2025Review
- Understanding Latine disparities in nocturnal wakefulness as a suicide risk factor.Sleep epidemiology · 2025Article
- Sleep disturbance and maladaptive sleep-related cognitions in borderline personality disorder in the longitudinal McLean Study of Adult Development.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025Article
- Dysfunctional Beliefs About Sleep in Suicidal Adolescents: Associations and Treatment Implications.Behavior therapy · 2025Article
8 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
11 authors at 1 institution in 1 country.
William V McCallDepartment of Psychiatry and Health Behavior, Medical College of Georgia at Augusta University (McCall, Rosenquist, Youssef, McCloud), and the Pharmacy Department, Augusta University Health (Phillips), Augusta, Ga.; Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine (Benca); Department of Medicine, Medical University of South Carolina, Charleston (Newman); Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, N.C. (Case); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Rumble); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, N.C. (Szabo, Krystal); Durham VA Health Care System, Durham, N.C. (Szabo); Langley Porter Psychiatric Hospital and Clinics and Department of Psychiatry, University of California, San Francisco, San Francisco (Krystal).
Ruth M BencaDepartment of Psychiatry and Health Behavior, Medical College of Georgia at Augusta University (McCall, Rosenquist, Youssef, McCloud), and the Pharmacy Department, Augusta University Health (Phillips), Augusta, Ga.; Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine (Benca); Department of Medicine, Medical University of South Carolina, Charleston (Newman); Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, N.C. (Case); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Rumble); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, N.C. (Szabo, Krystal); Durham VA Health Care System, Durham, N.C. (Szabo); Langley Porter Psychiatric Hospital and Clinics and Department of Psychiatry, University of California, San Francisco, San Francisco (Krystal).
Peter B RosenquistDepartment of Psychiatry and Health Behavior, Medical College of Georgia at Augusta University (McCall, Rosenquist, Youssef, McCloud), and the Pharmacy Department, Augusta University Health (Phillips), Augusta, Ga.; Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine (Benca); Department of Medicine, Medical University of South Carolina, Charleston (Newman); Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, N.C. (Case); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Rumble); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, N.C. (Szabo, Krystal); Durham VA Health Care System, Durham, N.C. (Szabo); Langley Porter Psychiatric Hospital and Clinics and Department of Psychiatry, University of California, San Francisco, San Francisco (Krystal).
Nagy A YoussefDepartment of Psychiatry and Health Behavior, Medical College of Georgia at Augusta University (McCall, Rosenquist, Youssef, McCloud), and the Pharmacy Department, Augusta University Health (Phillips), Augusta, Ga.; Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine (Benca); Department of Medicine, Medical University of South Carolina, Charleston (Newman); Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, N.C. (Case); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Rumble); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, N.C. (Szabo, Krystal); Durham VA Health Care System, Durham, N.C. (Szabo); Langley Porter Psychiatric Hospital and Clinics and Department of Psychiatry, University of California, San Francisco, San Francisco (Krystal).
Laryssa McCloudDepartment of Psychiatry and Health Behavior, Medical College of Georgia at Augusta University (McCall, Rosenquist, Youssef, McCloud), and the Pharmacy Department, Augusta University Health (Phillips), Augusta, Ga.; Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine (Benca); Department of Medicine, Medical University of South Carolina, Charleston (Newman); Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, N.C. (Case); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Rumble); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, N.C. (Szabo, Krystal); Durham VA Health Care System, Durham, N.C. (Szabo); Langley Porter Psychiatric Hospital and Clinics and Department of Psychiatry, University of California, San Francisco, San Francisco (Krystal).
Jill C NewmanDepartment of Psychiatry and Health Behavior, Medical College of Georgia at Augusta University (McCall, Rosenquist, Youssef, McCloud), and the Pharmacy Department, Augusta University Health (Phillips), Augusta, Ga.; Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine (Benca); Department of Medicine, Medical University of South Carolina, Charleston (Newman); Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, N.C. (Case); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Rumble); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, N.C. (Szabo, Krystal); Durham VA Health Care System, Durham, N.C. (Szabo); Langley Porter Psychiatric Hospital and Clinics and Department of Psychiatry, University of California, San Francisco, San Francisco (Krystal).
Doug CaseDepartment of Psychiatry and Health Behavior, Medical College of Georgia at Augusta University (McCall, Rosenquist, Youssef, McCloud), and the Pharmacy Department, Augusta University Health (Phillips), Augusta, Ga.; Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine (Benca); Department of Medicine, Medical University of South Carolina, Charleston (Newman); Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, N.C. (Case); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Rumble); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, N.C. (Szabo, Krystal); Durham VA Health Care System, Durham, N.C. (Szabo); Langley Porter Psychiatric Hospital and Clinics and Department of Psychiatry, University of California, San Francisco, San Francisco (Krystal).
Meredith E RumbleDepartment of Psychiatry and Health Behavior, Medical College of Georgia at Augusta University (McCall, Rosenquist, Youssef, McCloud), and the Pharmacy Department, Augusta University Health (Phillips), Augusta, Ga.; Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine (Benca); Department of Medicine, Medical University of South Carolina, Charleston (Newman); Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, N.C. (Case); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Rumble); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, N.C. (Szabo, Krystal); Durham VA Health Care System, Durham, N.C. (Szabo); Langley Porter Psychiatric Hospital and Clinics and Department of Psychiatry, University of California, San Francisco, San Francisco (Krystal).
Steven T SzaboDepartment of Psychiatry and Health Behavior, Medical College of Georgia at Augusta University (McCall, Rosenquist, Youssef, McCloud), and the Pharmacy Department, Augusta University Health (Phillips), Augusta, Ga.; Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine (Benca); Department of Medicine, Medical University of South Carolina, Charleston (Newman); Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, N.C. (Case); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Rumble); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, N.C. (Szabo, Krystal); Durham VA Health Care System, Durham, N.C. (Szabo); Langley Porter Psychiatric Hospital and Clinics and Department of Psychiatry, University of California, San Francisco, San Francisco (Krystal).
Marjorie PhillipsDepartment of Psychiatry and Health Behavior, Medical College of Georgia at Augusta University (McCall, Rosenquist, Youssef, McCloud), and the Pharmacy Department, Augusta University Health (Phillips), Augusta, Ga.; Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine (Benca); Department of Medicine, Medical University of South Carolina, Charleston (Newman); Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, N.C. (Case); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Rumble); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, N.C. (Szabo, Krystal); Durham VA Health Care System, Durham, N.C. (Szabo); Langley Porter Psychiatric Hospital and Clinics and Department of Psychiatry, University of California, San Francisco, San Francisco (Krystal).
Andrew D KrystalDepartment of Psychiatry and Health Behavior, Medical College of Georgia at Augusta University (McCall, Rosenquist, Youssef, McCloud), and the Pharmacy Department, Augusta University Health (Phillips), Augusta, Ga.; Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine (Benca); Department of Medicine, Medical University of South Carolina, Charleston (Newman); Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, N.C. (Case); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Rumble); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, N.C. (Szabo, Krystal); Durham VA Health Care System, Durham, N.C. (Szabo); Langley Porter Psychiatric Hospital and Clinics and Department of Psychiatry, University of California, San Francisco, San Francisco (Krystal).
Augusta University · US
Funding
1/3-Reducing Suicial Ideation Through Insomnia Treatment (REST-IT)R01MH095776 · NIMH · AUGUSTA UNIVERSITY · PI MCCALL, WILLIAM VAUGHN · 2012 to 2016
$1.2M3/3-Reducing Suicidal Ideation Through Insomnia Treatment (REST-IT)R01MH095778 · NIMH · UNIVERSITY OF WISCONSIN-MADISON · PI BENCA, RUTH M · 2012 to 2016
$991k2/3-Reducing Suicide Ideation Through Insomnia Treatment (REST-IT)R01MH095780 · NIMH · DUKE UNIVERSITY · PI KRYSTAL, ANDREW D · 2012 to 2016
$904kNIMH NIH HHS R01 MH095776NIMH NIH HHS R01 MH095778NIMH NIH HHS R01 MH095780
Abstract
objectiveThe authors sought to determine whether targeted treatment of insomnia with controlled-release zolpidem (zolpidem-CR) in suicidal adults with insomnia would provide a reduction in suicidal ideation superior to placebo.
methodsReducing Suicidal Ideation Through Insomnia Treatment was an 8-week three-site double-blind placebo-controlled parallel-group randomized controlled trial of zolpidem-CR hypnotic therapy compared with placebo, in conjunction with an open-label selective serotonin reuptake inhibitor. Participants were medication-free 18- to 65-year-olds with major depressive disorder, insomnia, and suicidal ideation. Suicidal ideation was the main outcome, measured first by the Scale for Suicide Ideation and second by the Columbia-Suicide Severity Rating Scale (C-SSRS).
resultsA total of 103 participants were randomly assigned to receive zolpidem-CR (N=51) or placebo (N=52) (64 women and 39 men; mean age=40.5 years). Zolpidem-CR had a robust anti-insomnia effect, especially in patients with the most severe insomnia symptoms. No significant treatment effect was observed on the Scale for Suicide Ideation (least squares mean estimate=-0.56, SE=0.83, 95% CI=-2.19, 1.08), but the reduction in scores was significantly positively related to improvement in insomnia after accounting for the effect of other depression symptoms. The C-SSRS indicated that zolpidem-CR had a significant treatment effect (least squares mean estimate=-0.26, SE=0.12, 95% CI=-0.50, -0.02). The advantage for zolpidem-CR in reducing suicidal ideation on the C-SSRS was greater in patients with more severe insomnia. No deaths or suicide attempts occurred.
conclusionsAlthough the results do not support the routine prescription of hypnotic medication for mitigating suicidal ideation in all depressed outpatients with insomnia, they suggest that coprescription of a hypnotic during initiation of an antidepressant may be beneficial in suicidal outpatients, especially in patients with severe insomnia.
Indexed as
Suicidal IdeationAdolescentAdultAgedDelayed-Action PreparationsDouble-Blind MethodDrug Therapy, CombinationFemaleHumansMaleMiddle AgedSelective Serotonin Reuptake InhibitorsSleep Aids, PharmaceuticalSleep Initiation and Maintenance DisordersYoung AdultZolpidemDelayed-Action PreparationsSelective Serotonin Reuptake InhibitorsSleep Aids, PharmaceuticalZolpidemInsomniaSleepSuicide
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Read underepoch 390
Registered trials
NCT04986007ClinicalTrials.gov
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.