Cukrowicz, Kelly C.; Otamendi, Ainhoa;

¶ … Cukrowicz, Kelly C.; Otamendi, Ainhoa; Pinto, Jennifer V.; Bernert, Rebecca a.; Krakow, Barry; Joiner Jr., Thomas E. (2006). The impact of insomnia and sleep disturbances on depression and suicidality. Dreaming, Vol 16(1) 1-10

Previous research indicates association between suicidality and sleep disturbances, suggesting that nightmares (I..e sleep disturabnces0 may exacerbate and result in depression leading to suicidality. The purpose of this study was to investigate the impact of sleep disturbances on depression and suicidal thoughts on a sample of college students. Results showed that insomnia and nightmares were predictors of depression, whilst nightmares alone were a significant predictor of suicidal ideation.

Further analysis showed that participants with elevated levels of insomnia and nightmares indicated differing levels of depression and suicidal ideation.

Whilst instruments used were reliable (Beck's depression and the Insomnia severity index) and the sample was large (222 participants), I found fault with the study in that the sample was extracted form one university only and that it was related to one age group. Students may have suffered form some other extraneous factor reductive tot the university itself. This is particularly so since we are talking about adolescents and college students who have a particularly challenging schedule and often go through pressures typical to adolescents (such s dating and studies). It may have been these that caused depression and suicidal ideation rather than nightmares.

It is clear that he study is pertinent to my subject, since depression is a bodily symptom and suicide certainly so. This study shows the relationship between nightmare, depression, and suicide.

2.Bernert RA; Joiner TE; Cukrowicz KC et al. (2005) Suicidality and sleep disturbances. SLEEP 28(9): 1135-1141.

A large amount of research correlates nightmares with suicide. However, it is unclear whether suicide is largely explained by depression and nightmares are a results. Bernert et al. investigated this issue by requesting 176 outpatients to complete measures on sleep disturbances, suicidal symptoms, and depression. Several sleep disturbances were evaluated with regard to suicidal ideation, including insomnia, nightmares, and sleep-related breathing symptoms. Regression analyses revealed that insomnia and nightmare symptoms were associated with both depressive symptoms and suicidality. After controlling for depressive symptoms, only nightmares demonstrated an association with suicidal ideation. This was particularly so with women compared to men. Post hoc analysis controlled for factors of sex and depression and concluded that nightmares were significantly related to suicidality.

This study was more reliable than the former in that, although a smaller sample (N=176), patients were from an outpatient clinic and more demographically diverse. The age ranged form 18-60; the instruments too were reliable; and the ethnic content was diverse too.

I found this valuable for study since it controls age and depression as related to suicidatliy, and shows clearly that nightmares are the determining factor.

3. Eric Mick, Joseph Biederman, Jennifer Jetton, and Stephen V. Faraone. (2000). Journal of Child and Adolescent Psychopharmacology. 10(3): 223-231.

Sleep-related disturbances are common in ADHD youths, but researchers found that they are commonly accounted for by comorbidity and pharmacotherapy . Researchers used standard sleep questionnaires to assess sleep problems and characteristics in ADHD (n = 122) and non-ADHD (n = 105) comparison youths. They concluded that ADHD may be one of the consequence of nightmares but is not an outcome of it.

This study is valuable to my study in that it teaches me to be skeptical regarding differentiating between outcome and cause.

4.

StRanjbaran, Z., Keefer, L., Farhadi, a., Stepanski, E., Sedghi, S. And Keshavarzian, a. (2007), Impact of sleep disturbances in inflammatory bowel disease. Journal of Gastroenterology and Hepatology, 22: 1748 -- 1753.

Study showed that inflammatory bowel disease (IBD) patients have significant sleep disturbance even when their disease is not active. This problem might affect quality of life, gastrointestinal symptoms and coping ability, and might potentially increase or decrease disease severity. A self-administered, mail-in questionnaire package was sent to 205 subjects using the Pittsburgh Sleep Quality Index (PSQI), a measure of disease severity and the IBD-Quality of Life Questionnaire. Interestingly enough, both IBD and irritable bowel syndrome (IBS) subjects thought that sleep and their disease status were correlated.

The tools are reliable although questionnaires are always riddled with problems. Sleep disturbances too may come from another cause or may be an outcome rather than determinant of IBD. Either way, sleep disturbances certainly impact QOL and therefore, it is argued, may have impact on body. In this way, this study coheres with the other studies used for my report and is helpful.

5.

Smith M.T., Haythornthwaite J.A. (2004). How do sleep disturbance and chronic pain inter-relate? Insights from the longitudinal and cognitive-behavioral clinical trials literature Sleep Medicine Reviews, 8 (2), pp. 119-132

Sleep disturbance may well be one of the most prevalent complaints of patients with chronically painful conditions. One of the elements of sleep disturbances -- in fact an integral part o if it -- is nightmares. This literature review suggests that the relationship between nightmares / sleep disturbances and chronic illness is reciprocal in that nightmares aggravate chronic illness, whereas chronic illness frequently eventuates in nightmares.