Insomnia, Hyperarousal, and Suicide in Psychosis-View Presentation Slides

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The presentation "Insomnia, Hyperarousal, and Suicide in Psychosis" hosted by the American Psychiatric Association delves into the interconnections between sleep disturbances, hyperarousal, and suicidal tendencies in patients with psychosis. The primary focus is on research linking insomnia with heightened suicide risk in psychiatric disorders, particularly in individuals with schizophrenia and schizoaffective disorders.<br /><br />Studies reveal a strong association between sleep disturbances like insomnia and increased suicidal behaviors across multiple psychiatric conditions, including depression, PTSD, panic disorder, and schizophrenia. Meta-analyses cited in the presentation confirm insomnia and nightmares as significant predictors of suicidal ideation and attempts.<br /><br />The webinar also introduced novel methods in assessing suicide risk, highlighting the potential utility of pupillometry—a test measuring the pupillary light reflex—as an effective marker for physiological arousal linked to suicide risk.<br /><br />Further, the presentation underscores the need for robust treatment approaches targeting insomnia in psychosis. Currently, guidelines are limited, and suggested treatments often involve psychoeducation on good sleep hygiene or using certain medications like sedating antipsychotics and eszopiclone, alongside cognitive behavioral therapy for insomnia (CBT-I). However, decisions regarding treatment should ideally involve shared decision-making between clinicians and patients.<br /><br />Finally, the session emphasized the importance of ongoing research and dialogue among mental health professionals to better understand and address the complex interplay between insomnia, psychopathology, and suicidal behaviors in patients at high risk for psychosis. The presentation forms part of continuing education aimed at enhancing knowledge of these critical issues and improving patient care outcomes.

Keywords

Insomnia

Psychosis

Suicide

Hyperarousal

Schizophrenia

Sleep disturbances

Pupillometry

Suicidal ideation

CBT-I

Mental health