Dr. Matt Walker

It's not that you see suicide ideation and suicide attempts and completion in a distributed manner equally across the 24 hour period.

When do they principally occur?

They occur in the late middle of the night.

and there's this almost a four to five hour period you know somewhere on average and again it's just an average somewhere between let's say 1 a.m and 4 a.m which turns out to be right at the lowest dip of your circadian rhythm and it could be circadian rhythm but i also think that there's something about of course the night timeness when no one else is around and it is just you bad point number one second as we've spoken about before on this episode

Negative thoughts are 10 times worse in the darkness of night than they are in the light of day.

And third, at that point, if you're awake, you're not asleep.

And we know sleep is providing this ballast to your mental health.

So on all three of those counts,

you see this very strong spike in suicide ideation, suicide attempt, and also suicide completion in this bewitching hour in the middle of the night.

There's a final piece in this suicide story, though, that is only just emerging.

if you are not getting sufficient sleep you are somewhere between two to three times more likely to go into that suicidal state which is a very significant number however when people started to measure another factor of sleep and particularly dream sleep which was the dream content itself

it became even more predictive.

And we've not really seen this very much in psychiatric conditions.

But what they found was that instead of using your sleep disruption or your lack of sleep as a predictor of your suicide risk, we use nightmares as a predictor of your suicide risk.

That predictive value, that risk went from about two to three times more likely to somewhere between five to eight times more likely.

there is something special going on with bad dreams and specifically nightmares that is even more predictive than this physiological thing that we call sleep itself.

And we'll probably come on to maybe some of the reasons why dreaming and particularly nightmares in the next episode on dreaming

could explain exactly why that is, but it's a new finding.

I don't think we can say much more about it now, but it is one of the most, I think, novel findings in the psychiatric sleep story that now dreams have come above and beyond simply sleep itself as a predictor of mental illness and specifically a form that will take your life tragically very quickly.

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