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Sleep and suicide : A relationship

We spend about a third of our life sleeping, we understand the importance of sleeping to a good degree, but is sleep important to our desire to stay alive?

Sleep and suicide
Importance of sleep in suicidal ideations

A recent study showed a relationship between total sleep time and suicidal ideation (thoughts of wanting to commit suicide). This should not come as a surprise for most of us, but it is interesting to note that the study indicates that other sleep parameters such as the amount of REM sleep (time we spend dreaming) or sleep onset latency (time it takes for us to fall asleep). It also seems that etiological factors such as age, sex or depression doesn't seem to moderate (impact) the association between reduced sleep time and suicidal ideation.

We've known for years that suicide rates are higher on certain days, for example Mondays, and even certain hours of the days - peaking around 2-3am, linking the possibility of sleep or rather, the lack of, having a strong impact on our desire to be alive. These studies are important to note because it plays into how we distribute our resources, such as for organizations like Befrienders, that provides a 24/7 hotline for people to call in if they have any mental health concerns, or a need to talk, and for some, even those with suicidal thoughts. They are at 603-76272929. Hopefully it gives an indication as to how they should allocate their resources. If you are having suicidal thoughts, please reach out to us at +018-2112 837, call Befrienders or call 999! There's always help around!

Any information we have is important especially when just last year, data from our Malaysian police is showing that suicide cases went up 81% between 2021 and 2020, at 1142 deaths in 2021. This is with the backdrop of more than 1 in 10 children and adolescents having suicidal thoughts, at 13.4%. We've known for years that the rate of people who are struggling with mental health issues in Malaysia is around 29%, close to 1 out of every 3 Malaysians.

1/3 Malaysians mental health issues
(1 out of every 3 Malaysians suffer from mental health issues)

(1 out of every 3 Malaysians suffer from mental health issues)

What can we do? Are there any tricks or tips that we can use to sleep better? Our sleep can be improved by improving our sleep hygiene. Sleep hygiene is more than just showering before going to bed. It consists of removing distractions/harmful stimuli from affecting our sleep negatively. Some of the simpler things to keep in mind when maintaining good sleep hygiene would be

  • Making sure that you go to bed and wake up at the same time everyday, even the weekends if you can! This will help manage the circadian clock in your body, telling your brain that it's sleepy time, and you'll naturally feel tired when it's time to sleep

  • Creating a good sleep environment! Make sure your bedroom is cool, dark and relaxed. Use darker curtains if necessary, turning off the lights or dimming it when it's close to bed time.

  • Sleep diet - You should avoid caffeine (that means no soft drinks/soda either, not just coffee or tea) after 3pm. Some people can consume caffeine later in the day and still sleep, but if you have problems sleeping, less caffeine is always better. You should avoid alcohol too, it helps us fall asleep faster, but then it affects our sleep quality resulting in us waking up middle of the night and having difficulty falling asleep later on, and you'll feel overall more tired in the end. You should also avoid having large meals later in the evening, no supper or midnight snacks!

  • Exercise! 30 mins a day would be very useful, avoid heavy exercise during the evening though. That'll increase your cortisol production too late in the day when your body is trying to wind down.

  • Remove distractions - phones, TVs, tablets, computers. Anything that might get you out of bed, or out of your sleep should be put away.

Sleep hygiene checklist
Checklist for sleep hygiene

If you're still having trouble sleeping despite doing your best in creating a good sleep hygiene, there's always hope. We have clinical psychologists who can work with you with a technique called Cognitive Behavioral Therapy for Insomnia (CBT-I), there are also sleep medications that can be safe if used under guidance as prescribed by our psychiatrists. Some medications have been shown to reduce suicidal thoughts as well when used to improve insomnia.

We'll spend this week exploring the relationship between sleep and different aspects of our mental health so stay tuned!


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