The link between sleep problems and suicidal thoughts and behaviours is made starkly clear in new research from The University of Manchester, published in the BMJ Open.

In this study, conducted by researchers from the University's School of Health Sciences alongside the University of Oxford, 18 participants were interviewed about the role sleep problems have on suicidal tendencies.

Three inter-related pathways to suicidal thoughts were identified arising from sleep problems. The first was that being awake at night heightened the risks of suicidal thoughts and attempts, which in part was seen as a consequence of the lack of help or resources available at night.

Secondly, the research found that a prolonged failure to achieve a good night's sleep made life harder for respondents, adding to depression, as well as increasing negative thinking, attention difficulties and inactivity.

Finally, respondents said sleep acted as an alternative to suicide, providing an escape from their problems. However, the desire to use sleep as an avoidance tactic led to increased day time sleeping which in turn caused disturbed sleeping patterns - reinforcing the first two pathways.