Suicidal ideation and suicide attempts: associations with sleep duration, insomnia, and inflammation

Abstract Background Sleep disturbance has been consistently identified as an independent contributor to suicide risk. Inflammation has emerged as a potential mechanism linked to both sleep disturbance and suicide risk. This study tested associations between sleep duration, insomnia, and inflammation on suicidal ideation (SI) and history of a suicide attempt (SA). Methods Participants included 2329 adults with current or remitted depression and/or anxiety enrolled in the Netherlands Study of Depression and Anxiety. Sleep duration, insomnia, past week SI, and SA were assessed with self-report measures. Plasma levels of C-reactive protein, interleukin-6, and tumor necrosis factor-α were obtained. Results Short sleep duration (⩽6 h) compared to normal sleep duration (7–9 h) was associated with reporting a prior SA, adjusting for covariates [adjusted odds ratio (AOR) 1.68, 95% CI 1.13–2.51]. A higher likelihood of SI during the past week was observed for participants with long sleep duration (⩾10 h) compared to normal sleep duration (AOR 2.22, 95% CI 1.02–4.82), more insomnia symptoms (AOR 1.44, 95% CI 1.14–1.83), and higher IL-6 (AOR 1.31, 95% CI 1.02–1.68). Mediation analyses indicated that the association between long sleep duration and SI was partially explained by IL-6 (AOR 1.02, 95% CI 1.00–1.05). Conclusions These findings from a large sample of adults with depression and/or anxiety provide evidence that both short and long sleep duration, insomnia symptoms, and IL-6 are associated with the indicators of suicide risk. Furthermore, the association between long sleep duration and SI may operate through IL-6.

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Sleep Duration Is Closely Associated with Suicidal Ideation and Suicide Attempt in Korean Adults: A Nationwide Cross-Sectional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18115594 ◽

2021 ◽

Vol 18 (11) ◽

pp. 5594

Author(s):

Yujin Ko ◽

Jieun Moon ◽

Sangsoo Han

Keyword(s):

Suicidal Ideation ◽

Suicide Attempt ◽

Sleep Duration ◽

Suicide Attempts ◽

Sleep Problems ◽

Survey Methods ◽

Self Report ◽

Short Sleep Duration ◽

Sampling Weights ◽

Increased Risk

Introduction: Suicidal ideation and suicide attempts are major risk factors for suicidal death, and sleep problems are associated with an increased risk for mental disorders. We investigated the relationship between sleep duration and suicidal ideation and suicide attempts in a representative sample of the Korean general population from a nationwide survey. Methods: We analyzed data collected from the Korea National Health and Nutrition Examination Survey VI and VII (2013–2018). Suicidal ideation was identified via self-report, and we accessed suicide attempt history. Sleep duration was divided into three categories: short sleep duration (SSD) (≤5 h), normal sleep duration (NSD) (>5 and <9 h), and long sleep duration (LSD) (≥9 h). Sampling weights were applied to obtain estimates for the general Korean population. Results: Overall, 4015 (12.0%), 25,609 (76.5%), and 3857 (11.5%) participants were in the SSD, NSD, and LSD groups, respectively. Among these groups, 7.2%, 2.8%, and 3.3% reported suicidal ideation; while 1.2%, 0.4%, and 0.7% reported a history of suicide attempts. Multiple regression analyses revealed that SSD was significantly more strongly associated with suicidal ideation (adjusted odds ratio (AOR) 1.46, p < 0.001) and attempts (AOR 2.05, p = 0.003) than NSD. No association was found between LSD and suicidal ideation/attempts. Conclusion: Sleep duration is significantly associated with suicidal behavior, and SSD was particularly closely related with an increased risk for suicidal ideation and suicide attempt. Clinicians should carefully consider sleep duration in suicidal patients.

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Defeat and Entrapment Mediate the Relationship between Insomnia and Suicidal Ideation in Young Adults

10.31234/osf.io/2qrcd ◽

2020 ◽

Author(s):

Danny Royston Russel Bradford ◽

Stephany Biello ◽

KIrsten Russell

Keyword(s):

Young Adults ◽

Suicidal Ideation ◽

Sleep Disturbance ◽

Suicide Risk ◽

Self Report ◽

Affective Outcomes ◽

Psychological Mechanisms ◽

And Behavior ◽

The Relationship ◽

Insomnia Symptoms

Objective- In recent years, there has been a growing interest in understanding the relationship between sleep disturbance and suicide. The current study aimed to advance understanding regarding the psychological processes driving these relationships, by examining if insomnia symptoms are related to suicidal ideation via perceptions of defeat and entrapment. Method- Participants (n = 260) completed an anonymous self-report survey online assessing insomnia symptoms, chronotype, defeat, entrapment, suicidal ideation and behavior, and a range of covariates. Insomnia symptoms were associated with an increased suicide risk(independent of depression). Results- Bivariate associations found insomnia severity to be related to poorer affective outcomes. The relationship between insomnia and suicidal ideation was mediated by perceptions of defeat and entrapment. Conclusions- Taken together, these findings shed light on the psychological mechanisms linking sleep disturbance and suicidal ideation by highlighting the role of defeat and entrapment. These findings have the potential to improve suicide risk assessment and prevention in young adults experiencing difficulties initiating or maintaining sleep.

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Sleep Duration is Closely Associated with Suicidal Ideation and Suicide Attempt in Korean Adults: A Nationwide Cross-sectional Study

10.21203/rs.3.rs-275335/v1 ◽

2021 ◽

Author(s):

Yujin Ko ◽

Ji Eun Moon ◽

Sangsoo Han

Keyword(s):

Suicidal Ideation ◽

Suicide Attempt ◽

Sleep Duration ◽

Suicide Attempts ◽

Sleep Problems ◽

Self Report ◽

Short Sleep Duration ◽

Sampling Weights ◽

Cross Sectional ◽

Increased Risk

Abstract Introduction: Suicidal ideation and suicide attempts are major risk factors for suicidal death, and sleep problems are associated with an increased risk for mental disorders. We investigated the relationship between sleep duration and suicidal ideation and suicide attempts in a representative sample of the Korean general population from a nationwide survey.Methods: We analyzed data collected from the Korea National Health and Nutrition Examination Survey VI and VII (2013–2018). Suicidal ideation was identified via self-report and we accessed suicide attempt history. Sleep duration was divided into three categories: short sleep duration (SSD) (≤5 h), normal sleep duration (NSD) (>5 and <9 h), and long sleep duration (LSD) (≥9 h). Sampling weights were applied to obtain estimates for the general Korean population.Results: Overall, 4015 (12.0%), 25,609 (76.5%), and 3857 (11.5%) participants were in the SSD, NSD, and LSD groups, respectively. Among these groups, 7.2%, 2.8%, and 3.3% reported suicidal ideation, 1.2%, 0.4%, and 0.7% reported a history of suicide attempts. Multiple regression analyses revealed that SSD was significantly more strongly associated with suicidal ideation (adjusted odds ratio [AOR] 1.46, p < 0.001) and attempts (AOR 2.05, p = 0.003) than NSD. No association was found between LSD and suicidal ideation/attempts. Conclusion: Sleep duration is significantly associated with suicidal behavior, and SSD was particularly closely related with an increased risk for suicidal ideation and suicide attempt. Clinicians should carefully consider sleep duration in suicidal patients.

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Abstract P335: Associations of Sleep Duration and Sleep Quality With Physical Performance in Older Adults --The Chicago Healthy Aging Study (CHAS)

Circulation ◽

10.1161/circ.137.suppl_1.p335 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

ThanhHuyen T Vu ◽

Kathryn J Reid ◽

Martha L Daviglus ◽

Daniel B Garside ◽

Kiang Liu ◽

...

Keyword(s):

Sleep Disturbance ◽

Sleep Duration ◽

Physical Performance ◽

Gait Speed ◽

Healthy Aging ◽

Handgrip Strength ◽

Short Sleep Duration ◽

Aging Study ◽

Normal Sleep ◽

And Performance

Background: Sleep duration (too short or too long) is associated with lower physical performance. However, the association of sleep duration and physical performance, taking into account the quality of sleep (e.g., sleep disturbance) in older populations, has not been thoroughly investigated. Methods: Using data from the Chicago Healthy Aging study conducted in 2007-10, we investigated a cross-sectional association of a combination of sleep duration and sleep disturbance with muscle strength (hand grip), and performance [4m gait speed and Short Physical Performance Battery (SPPB)]. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep duration [categorized as short (≤ 6 hours), normal (7-8 hours), and long (≥ 9 hours)] and sleep disturbance (defined as either cannot fall asleep within 30 minutes or waking up in the middle of the night or early morning three or more times per week). (See Table and Table Footnote for definitions of sleep duration and disturbance, and physical performance categories). Multivariable logistic regression analysis was used. Results: The study sample consists of 952 men and 350 women, ages 65-84 (mean age 71) in 2007-10; 9% were African American.12.6 % had SPPB score ≤ 8, 6.8 % had gait speed on 4 meter course < 0.8 m/s, and 23.4 % had low sex-BMI specific handgrip strength. As compared to the group with normal sleep duration (7-8 hours) without sleep disturbance, adjusted odds (95% confidence interval) of low gait speed <0.8 m/s in those with short sleep duration (≤ 6 hours) and sleep disturbance was much higher [2.00 (1.06-3.75)]. Similarly, the odds of low sex-BMI specific handgrip strength was about 2 times higher in those with long duration of sleep (≥ 9 hours), compared to those with normal sleep duration without sleep disturbance. No association was found for Short Physical Performance Battery (see Table). Conclusion: In older age, short sleep duration with poor quality as well as excessive sleep duration were associated with the greater likelihood of having low muscle strength and performance.

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Associations between fecal short-chain fatty acids and sleep continuity in older adults with insomnia symptoms

Scientific Reports ◽

10.1038/s41598-021-83389-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Faiga Magzal ◽

Carmel Even ◽

Iris Haimov ◽

Maayan Agmon ◽

Kfir Asraf ◽

...

Keyword(s):

Older Adults ◽

Fatty Acids ◽

Sleep Duration ◽

Sleep Onset ◽

Short Chain Fatty Acids ◽

Short Sleep Duration ◽

Short Sleep ◽

Sleep Continuity ◽

Normal Sleep ◽

Insomnia Symptoms

AbstractInsomnia is a disorder characterized by difficulty falling asleep and poor sleep continuity and is associated with increased risks for physical and cognitive decline. Insomnia with short sleep duration is considered the most biologically severe phenotype of the disorder. Evidence suggests that short-chain fatty acids (SCFAs), the main byproducts of fiber fermentation in the gut, may affect sleep via gut–brain communications. This study explores associations between SCFAs and sleep continuity and compares SCFA concentrations in short vs. normal sleep insomnia phenotypes in older adults. Fifty-nine participants with insomnia symptoms (≥ 65 years), completed 2 weeks of objective sleep monitoring (actigraphy), and were divided into short and normal sleep duration phenotypes via cluster analysis. Sleep measures included total sleep time (TST), sleep onset latency (SOL), sleep efficiency (SE), and wake after sleep onset (WASO). Stool samples were collected and fecal SCFA concentrations were determined by gas-chromatography-mass-spectrometry (GCMS). Higher concentrations of acetate, butyrate, and propionate, and total SCFAs, were associated with lower SE and longer SOL after controlling for Body Mass Index (BMI). Concentrations were higher in the short sleep duration phenotype. Age, BMI, TST, and SOL explained 40.7% of the variance in total SCFAs. Findings contribute to understanding pathways along the gut–brain axis and may lead to the use of SCFAs as biomarkers of insomnia phenotypes.

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Cognitive Dysfunction in Insomnia Phenotypes: Further Evidence for Different Disorders

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.688672 ◽

2021 ◽

Vol 12 ◽

Author(s):

Michelle Olaithe ◽

Melissa Ree ◽

Nigel McArdle ◽

Sara Donaldson ◽

Maria Pushpanathan ◽

...

Keyword(s):

Working Memory ◽

Executive Function ◽

Sleep Duration ◽

Sleep Problems ◽

Disease Process ◽

Self Report ◽

Sleep Stages ◽

Attention And Memory ◽

Short Sleep Duration ◽

Normal Sleep

Study Objectives: To determine cognitive profiles in individuals with short sleep duration insomnia (SSDI) and normal sleep duration insomnia (NSDI; also, paradoxical insomnia), compared to healthy sleepers.Method: Polysomnographic (PSG) and neuropsychological data were analysed from 902 community-based Raine Study participants aged 22 ± 0.6 years of whom 124 met criteria for insomnia (53 with NSDI and 71 with or SSDI) and 246 were classified as healthy with normal sleep (i.e., without insomnia or other sleep disorders). Measurements of self- report (attention and memory) and laboratory-assessed (attention, episodic memory, working memory, learning, and psychomotor function) cognition and mood, and PSG-based sleep stages (% total sleep time; %TST) were compared between these 3 groups.Results: In comparison to the healthy sleeper group, both insomnia groups had poorer self-reported attention, memory, mood, and sleep, and poorer laboratory-assessed attention (inconsistency). The NSDI group had less consistent working memory reaction time than healthy-sleepers or those with SSDI. The SSDI group had more inconsistency in executive function (shifting), and showed greater %TST in stage N1 and N3, and less REM sleep than either healthy-sleepers or those with NSDI.Conclusions: Individuals with NSDI demonstrated greater working memory inconsistency, despite no laboratory assessed sleep problems, implicating early signs of pathophysiology other than disturbed sleep. Those with SSDI demonstrated different sleep architecture, poorer attention (inconsistency), and greater executive function (inconsistency) compared to healthy-sleepers and those with NSDI, implicating sleep disturbance in the disease process of this phenotype.

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Long sleep duration is associated with cognitive frailty among older community-dwelling adults: results from West China Health and Aging Trend study

BMC Geriatrics ◽

10.1186/s12877-021-02455-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yunli Zhao ◽

Ying Lu ◽

Wanyu Zhao ◽

Yanyan Wang ◽

Meiling Ge ◽

...

Keyword(s):

Older Adults ◽

Sleep Duration ◽

Western China ◽

Short Sleep Duration ◽

Cognitive Frailty ◽

West China ◽

Aging Trend ◽

Short Sleep ◽

Long Sleep ◽

Normal Sleep

Abstract Objective To investigate the association between sleep duration and cognitive frailty among older adults dwelling in western China. Methods We used the baseline data from West China Health and Aging Trend (WCHAT) study. Sleep duration was classified as short sleep duration (< 6 h), normal sleep duration (6–8 h) and long sleep duration (≥ 9 h). Fried frailty criteria and Short Portable Mental Status Questionnaire were used to measure cognitive frailty. Multinomial logistic regression was conducted to estimate odds ratio (OR) and 95% confidence interval (CI). Results A total of 4093 older adults (age = 67.8 ± 5.9 years, 1708 males and 2385 females) were included in the analysis. The prevalence of cognitive frailty was 11.8% among older adults in western China. Approximately 11.9% participants had short sleep duration (< 6 h); 22.2% had a long sleep duration (≥ 9 h). After adjusting for covariates, only long sleep duration was significantly associated with high risk of cognitive frailty (OR = 2.07, 95%CI = 1.60–2.68, P < 0.001) in western China older adults compared to normal sleep duration. Conclusions Long sleep duration was significantly related to cognitive frailty in older adults. Intervention for long sleep duration may be helpful to prevent cognitive frailty. Trial registration Chinese Clinical Trial Registry: ChiCTR1800018895.

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Attachment Organization in Suicide Prevention Research

Crisis ◽

10.1027/0227-5910/a000231 ◽

2014 ◽

Vol 35 (1) ◽

pp. 60-66 ◽

Cited By ~ 10

Author(s):

Amanda Venta ◽

Carla Sharp

Keyword(s):

Risk Factors ◽

Suicidal Ideation ◽

Suicide Attempt ◽

Interpersonal Relationships ◽

Suicide Ideation ◽

Suicide Attempts ◽

Critical Role ◽

Self Report ◽

Future Research ◽

Self Harm

Background: Identifying risk factors for suicide-related thoughts and behaviors (SRTB) is essential among adolescents in whom SRTB remain a leading cause of death. Although many risk factors have already been identified, influential theories now suggest that the domain of interpersonal relationships may play a critical role in the emergence of SRTB. Because attachment has long been seen as the foundation of interpersonal functioning, we suggest that attachment insecurity warrants attention as a risk factor for SRTB. Aims: This study sought to explore relations between attachment organization and suicidal ideation, suicide attempts, and self-harm in an inpatient adolescent sample, controlling for demographic and psychopathological covariates. Method: We recruited 194 adolescents from an inpatient unit and assigned them to one of four attachment groups (secure, preoccupied, dismissing, or disorganized attachment). Interview and self-report measures were used to create four variables reflecting the presence or absence of suicidal ideation in the last year, single lifetime suicide attempt, multiple lifetime suicide attempts, and lifetime self-harm. Results: Chi-square and regression analyses did not reveal significant relations between attachment organization and SRTB, although findings did confirm previously established relations between psychopathology and SRTB, such that internalizing disorder was associated with increased self-harm, suicide ideation, and suicide attempt and externalizing disorder was associated with increased self-harm. Conclusion: The severity of this sample and methodological differences from previous studies may explain the nonsignificant findings. Nonsignificant findings may indicate that the relation between attachment organization and SRTB is moderated by other factors that should be explored in future research.

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Relaksasi Benson Untuk Durasi Tidur Pasien Penyakit Jantung Koroner

Jurnal Endurance ◽

10.22216/jen.v3i3.2788 ◽

2018 ◽

Vol 3 (3) ◽

pp. 556

Author(s):

Mulyanti Roberto Muliantino ◽

Tuti Herawati ◽

Masfuri Masfuri

Keyword(s):

Cardiac Rehabilitation ◽

Sleep Duration ◽

Intervention Group ◽

Self Report ◽

Pharmacological Intervention ◽

Control Group ◽

P Value ◽

Short Sleep Duration ◽

Short Sleep ◽

Coronary Arterial Disease

Coronary Arterial Disease (CAD) is one of cardiovaskular disease that remain leading cause death and disability. Short sleep duration is the major symptoms in patients with CAD, during recovery period after cardiac events and during cardiac rehabilitation. Benson’s relaxation is one of relaxation as modalities therapy to increase sleep duration, however few studies related to this technique in planned intervention. This study was to measured the effectiveness of Benson’s relaxation in short sleep duration of CAD patients during cardiac rehabilitation. It was a quasi experimental pretest posttest control group design. This study included 29 respondens in Dr.M.Djamil Hospital were assigned to intervention group which receiving Benson’s relaxation technique (n=15) and control group with routine care (n=14). Benson’s relaxation technique was administered for 5 days 2 times a day, each 20 minutes to intervention group. Short sleep duration was measured using sleep diary (self report). The result indicated significant increasing in mean of sleep duration before and after Benson’s relaxation in intervention group (p value < 0,001). The study concluded that Benson’s relaxation technique is an effective non-pharmacological intervention to increase sleep duration in CAD patients. Penyakit jantung koroner menjadi masalah kardiovaskular yang mengakibatkan angka mortalitas yang tinggi. Durasi tidur pendek termasuk salah satu keluhan utama pasien penyakit jantung koroner pada masa recovery setelah serangan dan menjalani rehabilitasi fase 2. Relaksasi Benson merupakan teknik relaksasi sebagai terapi modalitas untuk mengurangi keluhan durasi tidur pendek, namum belum banyak penelitian terkait intervensi ini. Penelitian ini bertujuan untuk mengidentifikasi pengaruh relaksasi Benson terhadap durasi tidur pasien penyakit jantung koroner yang menjalani rehabilitasi fase 2. Penelitian ini menggunakan desain Quasi Eksperimen dengan pendekatan control group pretest posttest design pada 29 responden di RSUP. Dr.M.Djamil Padang yang dibagi dalam dua kelompok (kelompok intervensi dan kelompok kontrol). Hasil penelitian menunjukan ada perbedaan rerata durasi tidur yang signifikan antara sebelum dan setelah dilakukan intervensi relaksasi Benson pada kelompok intervensi (p value < 0,001). Simpulan hasil penelitian ini dapat menjadi salah satu terapi modalitas bagi perawat untuk mengatasi masalah durasi tidur pendek pada pasien penyakit jantung koroner.

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Causal associations of short and long sleep durations with 12 cardiovascular diseases: linear and nonlinear Mendelian randomization analyses in UK Biobank

European Heart Journal ◽

10.1093/eurheartj/ehab170 ◽

2021 ◽

Author(s):

Sizhi Ai ◽

Jihui Zhang ◽

Guoan Zhao ◽

Ningjian Wang ◽

Guohua Li ◽

...

Keyword(s):

Heart Disease ◽

Arterial Hypertension ◽

Ischaemic Heart Disease ◽

Sleep Duration ◽

Mendelian Randomization ◽

Short Sleep Duration ◽

Short Sleep ◽

Causal Risk Factor ◽

Long Sleep ◽

Artery Disease

Abstract Aims Observational studies have suggested strong associations between sleep duration and many cardiovascular diseases (CVDs), but causal inferences have not been confirmed. We aimed to determine the causal associations between genetically predicted sleep duration and 12 CVDs using both linear and nonlinear Mendelian randomization (MR) designs. Methods and results Genetic variants associated with continuous, short (≤6 h) and long (≥9 h) sleep durations were used to examine the causal associations with 12 CVDs among 404 044 UK Biobank participants of White British ancestry. Linear MR analyses showed that genetically predicted sleep duration was negatively associated with arterial hypertension, atrial fibrillation, pulmonary embolism, and chronic ischaemic heart disease after correcting for multiple tests (P < 0.001). Nonlinear MR analyses demonstrated nonlinearity (L-shaped associations) between genetically predicted sleep duration and four CVDs, including arterial hypertension, chronic ischaemic heart disease, coronary artery disease, and myocardial infarction. Complementary analyses provided confirmative evidence of the adverse effects of genetically predicted short sleep duration on the risks of 5 out of the 12 CVDs, including arterial hypertension, pulmonary embolism, coronary artery disease, myocardial infarction, and chronic ischaemic heart disease (P < 0.001), and suggestive evidence for atrial fibrillation (P < 0.05). However, genetically predicted long sleep duration was not associated with any CVD. Conclusion This study suggests that genetically predicted short sleep duration is a potential causal risk factor of several CVDs, while genetically predicted long sleep duration is unlikely to be a causal risk factor for most CVDs.

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