Borderline personality disorder (BPD) may be related to an increased risk for suicide through the relation with insomnia symptoms, according to research published in The Journal of Affective Disorders. BPD is associated with both high rates of suicide risk and sleep problems such as insomnia.
To assess the possible indirect effect of BPD traits on suicide risk through insomnia and/or nightmares, researchers recruited 281 participants to complete a study online. Researchers assessed BPD symptoms, history of suicidal thoughts or behaviors, insomnia symptoms, and distress related to nightmares.
BPD symptoms were significantly correlated with suicide risk insomnia, and nightmares and BPD traits had an indirect effect on suicide risk. However, nightmares were not related to suicide risk. The results suggested that sleep may improve as a result of treatment for BPD. Overall, nonrecovered patients with BPD tended to have longer sleep onset latency, higher rates of sleep medication use, and increased daytime dysfunction resulting from sleep disturbances, even when controlling for age, sex, depression, anxiety, and primary sleep disorders.
The study was limited by its sole reliance on self-reported measures, as well as by enrolling subjects from the general population rather than using a clinical sample. Additionally, other potential cofounders, such as psychotic symptoms or adverse life events, were not assessed.
The clinical implications of the study revolve around the treatment of insomnia. Researchers concluded that “assessing and treating sleep problems within individuals with BPD may result in a lower risk for suicide.” Future research should further investigate how the treatment of insomnia could alleviate some of the suicide risk among patients with BPD.
DeShong HL, Tucker RP. Borderline personality disorder traits and suicide risk: the mediating role of insomnia and nightmares. J Affect Disord. 2018;244:85-91.