Dataset Information

Association of insomnia phenotypes based on polysomnography-measured sleep duration with suicidal ideation and attempts.

ABSTRACT:

Objective

To assess the association of insomnia phenotypes, being insomnia with short sleep duration (ISSD) and insomnia with normal sleep duration (INSD), with suicidality in a randomly selected population-based sample.

Methods

Data were analyzed from the Penn State Adult Cohort. Participants (N = 1741, 52.5 years, 57.4% female) were randomly recruited from the general population between January 1990 through March 1999 and mortality data were available through December 2018. Insomnia symptoms were defined as self-reports of moderate-to-severe difficulties initiating or maintaining sleep, early morning awakening and non-restorative sleep, or having chronic insomnia (n = 719). Short sleep duration was defined as <6 hours of in-lab polysomnography-measured sleep duration (n = 879). Suicidality (SAI; n = 102) was ascertained by a lifetime history of suicidal ideation (SI; n = 84), suicide attempts (SA; n = 48) or death by suicide (DBS; n = 10).

Results

Compared to normal sleepers who slept ≥6 hours, participants with ISSD and INSD were associated with 1.72-fold and 2.22-fold increased odds of SAI, respectively; these associations were significant for SI, with 2.09-fold and 2.24-fold increased odds, respectively, but not for SA, after adjusting for physical and mental health comorbidities. ISSD and INSD differed in SAI age of onset and hospitalizations after SA.

Conclusions

The results of this cohort study suggest that both INSD and ISSD phenotypes are associated with increased suicidal ideation, while the INSD phenotype has an earlier age of onset and is more likely to experience hospitalizations after attempting suicide. These results highlight the importance of targeting insomnia symptoms to help prevent suicide.

SUBMITTER: Saulnier KG

PROVIDER: S-EPMC9378467 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Association of insomnia phenotypes based on polysomnography-measured sleep duration with suicidal ideation and attempts.

Saulnier Kevin G KG Singh Rupsha R Lenker Kristina P KP Calhoun Susan L SL He Fan F Liao Duanping D Vgontzas Alexandros N AN Bixler Edward O EO Fernandez-Mendoza Julio J

Sleep health 20220619 4

<h4>Objective</h4>To assess the association of insomnia phenotypes, being insomnia with short sleep duration (ISSD) and insomnia with normal sleep duration (INSD), with suicidality in a randomly selected population-based sample.<h4>Methods</h4>Data were analyzed from the Penn State Adult Cohort. Participants (N = 1741, 52.5 years, 57.4% female) were randomly recruited from the general population between January 1990 through March 1999 and mortality data were available through December 2018. Inso ...[more]

PMID: 35732555

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Project description:Study objectivesSleep disturbance is significantly associated with suicidal ideation. However, the majority of past research has examined the relationship between insomnia and suicidality. The current exploratory study examined the relationship of circadian rhythm dysregulation (eveningness, seasonality, and rhythmicity) with suicidality.MethodsWe examined the association of insomnia, eveningness, seasonality, and rhythmicity with suicidal ideation in 103 participants with depression, insomnia, and suicidality within a larger 8-week double-blinded randomized control trial primarily examining whether cautious use of zolpidem extended-release or placebo reduced suicidal ideation. All participants additionally received an open-label selective serotonin reuptake inhibitor. Methodological strengths of the current analyses included consideration of multiple sleep-wake constructs, adjustment for relevant covariates, investigation of relationships over the course of treatment, and use of both self-report measures and objective measurement with actigraphy.ResultsOver the course of treatment, self-reported eveningness and greater insomnia severity were independently correlated with greater suicidal ideation, whereas actigraphic delayed sleep timing was related to suicidal ideation at a trend level. At the end of treatment, those with greater suicidal ideation demonstrated lower actigraphic activity levels. There were no significant relationships between self-reported seasonality and actigraphic measures of sleep disturbance and suicidality.ConclusionsSelf-reported delays in sleep timing, objectively lower activity levels, and self-reported insomnia severity correlated independently with greater suicidal ideation in those with depression, insomnia, and suicidality. These exploratory findings highlight the need to consider sleep-wake constructs more broadly in those with suicidality in future research studies in order to improve more definitively both assessment and intervention efforts.Clinical trial registrationRegistry: ClinicalTrials.gov; Name: Reducing Suicidal Ideation through Insomnia Treatment; URL: https://clinicaltrials.gov/ct2/show/NCT01689909; Identifier: NCT01689909 Rumble ME, McCall MV, Dickson DA, Krystal AD, Rosenquist PB, Benca RM. An exploratory analysis of the association of circadian rhythm dysregulation and insomnia with suicidal ideation over the course of treatment in individuals with depression, insomnia, and suicidal ideation. J Clin Sleep Med. 2020;16(8):XXX-XXX.

Project description:Importance:Suicidal ideation and suicide attempt (suicidality) are common in adolescence and a public health concern. Childhood depression is a key risk factor for later suicidality and often co-occurs with irritability. No study to date has examined the joint association of depressive mood and irritability during childhood with later suicidality. Objective:To investigate the association of childhood irritability and depressive/anxious mood profiles with adolescent suicidality. Design, Setting, and Participants:This population-based cohort study included 1430 participants in the Québec Longitudinal Study of Child Development. Participants underwent assessment yearly or bi-yearly (5 months to 17 years). Data were collected from March 16, 1998, through July 17, 2015. Exposures:Profiles defined by the joint developmental trajectories of irritability and depressive/anxious mood at 6 to 12 years of age. Main Outcomes and Measures:Self-reported past-year suicidality (ie, serious suicidal ideation or suicide attempt) at 13, 15, and 17 years of age. Irritability and depressive/anxious mood were assessed using teacher report 5 times from 6 to 12 years of age. Results:The study included 1430 participants (676 boys [47.3%] and 754 girls [52.7%]) followed up to 17 years of age. Group-based multitrajectory modeling identified the following profiles: combined no irritability and low depressive/anxious mood with low irritability and low depressive/anxious mood (831 [58.1%]; reference group), moderate irritability and low depressive/anxious mood (353 [24.7%]), high depressive/anxious mood only (94 [6.6%]), and high irritability and depressive/anxious mood (152 [10.6%]). Children with high irritability and high depressive/anxious mood reported higher rates of suicidality (25 of 152 [16.4%]) compared with the group with the lowest symptom levels (91 of 831 [11.0%]). In logistic regression analyses, the high irritability and depressive/anxious mood profile (odds ratio [OR], 2.22; 95% CI, 1.32-3.74; number needed to be exposed [NNE], 18) was associated with suicidality. To a lesser extent, the moderate irritability and low depressive/anxious mood profile was also associated with suicidality (OR, 1.51; 95% CI, 1.02-2.25; NNE = 48). The high depressive/anxious mood only profile was not associated with later suicidality (OR, 0.96; 95% CI, 0.47-1.95; NNE = -320). The high irritability and depressive/anxious mood profile was associated with a higher suicidal risk compared with the depressive/anxious mood only profile (OR, 2.28; 95% CI, 1.02-5.15). Girls with the high irritability and high depressive/anxious mood profile had higher risk for suicidality (OR, 3.07; 95% CI, 1.54-6.12; NNE = 5). Conclusions and Relevance:Children with high irritability and depressive/anxious mood and, to a lesser extent, with moderate irritability only had a higher suicidal risk during adolescence compared with children with low symptom levels. Early manifestation of chronic irritability during childhood, especially when combined with depressive/anxious mood, may be associated with an elevated risk for adolescent suicidality. The putatively causal role of irritability should be investigated.

Project description:BackgroundPrevious work has shown that poor sleep is a prospective risk factor for suicide in clinical populations and might contribute to risk in the general population. The present study evaluated whether sleep distress, onset insomnia, and insufficient sleep are associated with suicide ideation in university students and athletes participating in the 2011-2014 National College Health Assessment (NCHA; n = 113,185).MethodsIn the NCHA survey, students self-reported the presence or absence of suicide ideation within the past 12 months. SLEEP DISTRESS was assessed with an item indicating that "sleep difficulties" were "particularly traumatic or difficult to handle." ONSET INSOMNIA was assessed as at least 3 nights per week where survey participants reported an "extremely hard time falling asleep." INSUFFICIENT SLEEP was operationalized as the number of days per week where the participants felt they did not get "enough sleep to feel rested." All variables were yes/no except INSUFFICIENT SLEEP, which was categorized as 0-1 (reference), 2-3, 4-5, or 6-7 nights. Binary logistic regression analyses examined suicide ideation as the outcome and sleep variable as a predictor, adjusted for age, sex, year in school, recent depressed mood, and survey year. Associations within student-athletes were likewise assessed.Results7.4% of students reported suicide ideation within the past 12 months. In adjusted models, this was significantly associated with SLEEP DISTRESS (OR = 3.01, 95% CI [2.86, 3.16], p < 0.0001), ONSET INSOMNIA (OR = 1.95, 95% CI [1.86, 2.04], p < 0.0001), as well as INSUFFICIENT SLEEP (4-5 nights, OR = 1.41, 95% CI [1.28, 1.56], p < 0.0001; 6-7 nights, OR = 1.92, 95% CI [1.74, 2.13], p < 0.0001). Although suicide ideation was less common among athletes, ORs were similar for athletes for all sleep variables of interest.ConclusionSleep distress, onset insomnia, and insufficient sleep were all strongly related to suicide ideation among university students. These relationships were the same among collegiate athletes, even though this group reported less overall suicide ideation. Our findings suggest that university students may benefit from educational materials linking sleep disruption to maladaptive thinking and suicide ideation.

Dataset Information

Association of insomnia phenotypes based on polysomnography-measured sleep duration with suicidal ideation and attempts.

Objective

Methods

Results

Conclusions

Publications

Association of insomnia phenotypes based on polysomnography-measured sleep duration with suicidal ideation and attempts.

Similar Datasets

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