P073 Examining the Complex Relationships Among Insomnia, PTSD, Psychological Distress, and Suicidal Ideation in Firefighters.

INTRODUCTION: Firefighters endure sleep disruption and exposure to traumatic events - inherent occupational stressors that may contribute to insomnia, psychological distress, and PTSD. These factors are interrelated, with around 70% of individuals with PTSD experiencing co-occurring sleep problems but it remains unclear if insomnia has a unique effect on the risk of suicidality. The aim of this study was to investigate if there was an association between insomnia and suicidal ideation, above and beyond PTSD symptom severity and psychological distress. METHODS: Firefighters (n=578) self-reported their sleep problems, PTSD symptom severity, psychological distress, and suicidal ideation and attempts. Logistic regression was used to estimate the association between insomnia and suicidality and whether insomnia was associated with suicidality, above and beyond PTSD symptom severity and psychological distress. RESULTS: Insomnia was positively associated with suicidal ideation; with every one unit increase in insomnia, the odds of suicidal ideation increased by 1.42. However, the significance of the association between insomnia and suicidal ideation did not remain when accounting for PTSD symptom severity and psychological distress. CONCLUSION: These findings suggest an association between insomnia and suicidal ideation in firefighters, as part of the impact of PTSD and psychological distress, rather than unique to these risk factors. Although interventions to target sleep problems in firefighters may have benefits for reducing risk of suicidality, our findings suggest a more holistic mental health approach may be more successful.