Suicide remains the second leading cause of death among young people, but factors that predict increased risk of suicide have not been characterized, write Rebecca C. Cox, M.D., of the University of Colorado, Boulder, and colleagues.
“Sleep disturbances are a promising modifiable risk factor for acute changes in suicide risk,” the researchers noted. “Previous studies have found that various aspects of sleep disturbance are associated with elevated SI, including insomnia symptoms, both short and long sleep duration, nighttime awakenings, and nightmares. “
However, researchers said there was limited data on the impact of nighttime sleep disturbances on suicide risk. They found that using the Ecological Momentary Assessment (EMA) to assess day-to-day fluctuations in sleep provides more insight into the relationship between different components of sleep disturbances and changes in suicide risk. I hypothesized that it was possible.
inIn the psychiatric study, researchers recruited 102 young people aged 18 to 35 with a history of suicidal behavior. 74.5% were female and 64.7% were Caucasian. Participants answered seven semi-random surveys per day about their waking-to-sleep schedule over a period of 21 days. Each survey asked participants to report whether they had experienced suicidal ideation (SI) since the previous survey. The researchers investigated intra- and inter-individual sleep variables, including bedtime, sleep onset latency, sleep onset, number of awakenings, wakes after sleep onset, sleep duration, sleep timing, sleep quality, and nightmares.
Overall, nightmares had a significant positive effect on passive SI, but no significant effect on active SI, at both individual and interpersonal levels. Sleep latency showed a significant positive effect on passive SI and active SI at the interpersonal level, indicating that “participants who took longer to fall asleep on average had better passive SI and active SI during the sampling period.” more likely to experience SI,” the researchers noted. .
In addition, the next day after a night with longer waking time between sleep onsets was the day with a higher likelihood of passive and active SI. Similarly, the days after nights with worse-than-usually reported sleep quality were days with an increased likelihood of passive and active SI. Sleep timing and sleep duration did not significantly affect SI at the intra- or inter-individual level.
“Remarkably, reverse model testing found no association between daily passive or active SI and subsequent nocturnal sleep components, and no association between sleep disturbances and subsequent SI.” suggests that there is a one-way relationship,” the researchers said in a discussion. If future studies replicate the findings, they may support the inclusion of sleep difficulties in standard risk assessments as a way to identify risk for SI and initiate preventive approaches, the study said. they said.
The findings of the study are limited by several factors, the researchers noted, including the possibility of unmeasured variables affecting the association between sleep and SI. Other limitations include the lack of data on more severe levels of SI such as planning and intention and suicidal behavior such as preparatory behaviors, aborted attempts, and actual attempts. Also, the findings may not be generalizable to other age groups, such as children, adolescents and the elderly, the researchers said.
More research is needed to determine which sleep-disordered components are acute risk factors for which suicide-related outcomes, the researchers said. However, this study is the first to provide evidence of daily sleep disturbance as a short-term predictor of SI in young adults, the researchers concluded.
This research was supported in part by the National Institutes of Health. The researchers had no economic disputes to disclose.