Reducing Suicidal Ideation Through Insomnia Treatment (REST-IT): A Randomized Clinical Trial

What is it about?

Insomnia is a risk factor for suicide, but there have been no prior studies of whether targeted pharmacologic treatment of insomnia would reduce suicidality in depressed patients with insomnia. We randomly assigned suicidal, depressed outpatients with insomnia to either zolpidem-controlled release versus placebo at bedtime for 8 weeks, while also openly prescribing a selective serotonin reuptake inhibitor. The patients receiving zolpidem-controlled release had a greater decrease in insomnia symptoms and suicidal thoughts as compared with those who received placebo, especially among those with the highest degree of insomnia symptoms. There were no suicide attempts among the participants and they showed a high degree of adherence to the protocol. We conclude that there is value in providing targeted treatment of insomnia in suicidal depressed outpatients with insomnia, and that clinical trials in samples of these patients can be undertaken safely

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