Presence and Persistence of Sleep-Related Symptoms and Suicidal Ideation in Psychiatric Inpatients

Crisis ◽  
2014 ◽  
Vol 35 (6) ◽  
pp. 398-405 ◽  
Author(s):  
Michael R. Nadorff ◽  
Thomas E. Ellis ◽  
Jon G. Allen ◽  
E. Samuel Winer ◽  
Steve Herrera

Background: Although sleep is an important risk factor for suicidal behavior, research has yet to examine the association between sleep problems and suicidality across the course of inpatient treatment. This study examined the relationship among sleep-related symptoms and suicidal ideation across inpatient treatment. Aims: To examine whether poor sleep at admission longitudinally predicts less improvement in suicidal ideation over the course of treatment. Further, to examine whether suicidal ideation is reduced in patients whose sleep does not improve. Method: The study utilized the Beck Depression Inventory (BDI)-II, which contains items measuring depressive symptoms, sleep-related symptoms, and suicidal ideation. The study sample consisted of 1,529 adult psychiatric inpatients. Patients were assessed at admission, biweekly, and at treatment termination. Results: Admission fatigue, loss of energy, and change in sleep pattern were associated with higher levels of suicidal ideation at admission and discharge. Fatigue at admission predicted suicidal ideation at termination independent of admission depression and suicidal ideation. Individuals whose sleep did not improve over the course of treatment had significantly higher suicidal ideation scores at termination relative to those whose sleep symptoms improved, after controlling for sleep, depression, and suicidal ideation scores at admission. Conclusion: These findings suggest that persistence of sleep-related symptoms warrants clinical attention in the treatment of suicidal patients.

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Mutia Annisa ◽  
Dwi Nurviyandari Kusuma Wati

<p class="AbstractContent"><strong>Objective:</strong> Elderly are at risk of poor slepp quality and other health problems due to reduced sleep satisfaction. The objective of this study was to explore the association between sleep hygiene and sleep quality in elderly.</p><p class="AbstractContent"><strong>Methods: </strong>This was a descriptive study with cross sectional design. The study was conducted in four elderly care institutions in Jakarta, Indonesia, involving a purposive sample of 103 elderly aged 60 to 111 years old. Data were collected using Sleep Hygiene Index (SHI) and Pittsburgh Sleep Quality Index (PSQI).</p><p class="AbstractContent"><strong>Results:</strong> Over half of the residents had poor sleep hygiene (51.5%) and more than three quarter (81.6%) had poor sleep quality. The study revealed that there was a highly significant relationship between sleep hygiene and sleep quality (p = 0.001). The study also showed that those with poor sleep hygiene were 7.834 times more likely to have poor sleep quality.<strong></strong></p><p class="AbstractContent"><strong>Conclusion: </strong>Nurses need to include interventions that may address residents’ sleep problems. They also need to promote sleep hygiene and improve residents’ sleep quality.<strong></strong></p><strong>Keywords: </strong>elderly, institution, sleep hygiene, sleep quality


2021 ◽  
Author(s):  
Lindsay Dewa ◽  
Sofia Pappa ◽  
Talya Greene ◽  
James Cooke ◽  
Lizzie Mitchell ◽  
...  

BACKGROUND Patients are at high risk of suicidal behaviour and death by suicide immediately following discharge from an inpatient psychiatric hospital. Furthermore, there is a high prevalence of sleep problems in inpatient settings which is associated with worse outcomes following hospitalisation. However, it is unknown whether poor sleep is associated with suicidality following initial hospital discharge. Our study aim is to examine the relationship between sleep and suicidality in discharged patients using ecological momentary assessment (EMA). OBJECTIVE To examine the relationship between subjective and objective sleep parameters and suicidality in young psychiatric inpatients transitioning to the community, and to explore the underlying mechanisms of this relationship using an adapted Integrated Motivational-Volitional (IMV) model. METHODS Our study will be the first co-produced prospective EMA using a wearable device to examine the sleep-suicide relationship during the transition from acute inpatient care to the community. Prospectively discharged inpatients aged 18-35 with a mental disorder (n>50) will be assessed for eligibility and recruited across two sites. Data on suicidal ideation, behaviour and imagery, non-suicidal self-harm and imagery, defeat, entrapment, and hopelessness, affect and sleep will be collected on the Pro-Diary V wrist-worn electronic watch for up to 14 days. Objective sleep and daytime activity will be measured using the inbuilt MotionWare software. Questionnaires will be administered face-to-face at baseline and follow-up while data will also be collected on the acceptability and feasibility of using the Pro-Diary V watch to monitor the transition following discharge. The study has been, and will continue to be, co-produced with young people with experience of being in an inpatient setting and suicidality. RESULTS South Birmingham Research Ethics Committee (Ref: 21/WM/0128) approved the study on June 28th 2021. We expect to see a relationship between poor sleep and post-discharge suicidality. Results will be available in 2022. CONCLUSIONS This will be the first EMA study to examine the relationship between sleep and suicidality, and to apply the IMV model in young patients transitioning from psychiatric hospital to community. We expect findings will directly influence policy and clinical practice, including the introduction of digital monitoring of suicidality and/or sleep before and after initial hospital discharge.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S678-S678
Author(s):  
Melanie Stearns ◽  
Danielle K Nadorff

Abstract Recent evidence has shown that poor quality sleep is associated with depression, particularly among older individuals (Bao et al., 2017; Nadorff, Fiske, Sperry, & Petts, 2012). Moreover, given the high prevalence of depressive symptoms among older adults, it is important to identify possible risk factors of poor sleep quality. One possible risk factor is being a custodial grandparent (raising one’s grandchildren), as increased caregiving responsivities are associated with increased depressive symptoms (Brand-Winterstein, Edelstein, & Bachner, 2018). Based upon these previous findings, the current study examines the effect of custodial status on the relation between sleep quality and depressive symptoms. The sample (N = 466) was a subset of individuals recruited in the second wave of the MIDUS biomarkers project completed in 2009 who answered the sleep, caregiving, and depressive symptoms variables of interest. Measures included the Center for Epidemiological Studies Depression Scale (CESD), the Pittsburgh Sleep Quality Index (PSQI), and a question regarding custodial grandparent status. The current study aimed to examine whether poor sleep quality might serve as a risk factor for experiencing depressive symptoms and how custodial grandparents might differ from other older adults. Moderation analyses were conducted using SPSS’ Process macro on the sample. The interaction between global sleep quality and custodial grandparent status was significant in predicting depressive symptoms, t (1, 465) = 3.90, p = .04, such that custodial grandparents reported a stronger positive correlation between greater global sleep problems and depressive symptoms than non-custodial grandparents. Implications, future directions, and limitations are discussed.


2017 ◽  
Vol 41 (S1) ◽  
pp. S440-S441
Author(s):  
I. Holdø ◽  
S. Skurtveit ◽  
M. Handal ◽  
J.G. Bramness

IntroductionSleep problems are common in infancy. Some infants are prescribed sleep-inducing drugs even if not approved for the age group. Poor sleep as toddler is a risk factor for development of behavioral problems in childhood. It is unknown if this is true also for attention deficit and hyperactivity disorder (ADHD).ObjectivesTo evaluate two sources of information on toddler drug use (mother-reported questionnaire-data and prescription database for hypnotic drugs for children aged 0–18 months) and see if these predict receiving a later diagnosis of ADHD.AimsAre sleeping problems as measured by the use of hypnotics in toddlers a risk factor for ADHD?MethodsPrescription database information data was collected for 47,413 children participating in the Norwegian Mother and Child Cohort, where mothers report on toddler drug use. These two datasets were used as predictors of diagnoses of ADHD as seen in the Norwegian Patients Registry in a 7-year follow up period.ResultsAgreement between mother-reported drug use and hypnotics use as measured was less than 50% for all hypnotics (min 19% and max 48%). The two datasets will be further used to investigate the relationship between toddler drug use and a later childhood diagnosis of ADHD.ConclusionsConsidering the low to moderate agreement between mother-reported survey data and data from prescription databases it is of value to use both data sources in a study looking at the predictive value of sleeping problems and hypnotics use in toddlers on later development of ADHD.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2020 ◽  
pp. 105984052092192
Author(s):  
Ji-Su Kim ◽  
Yeji Seo

The purpose of the study is to identify the relationships between allergic disease, suicidal ideation, and plans among Korean adolescents. Additionally, we examined the mediating role of short sleep duration. We analyzed nationally representative cross-sectional data from the 12th to 14th Korea Youth Risk Behavior Web-Based Survey; the final sample included 164,725 middle school–aged and high school–aged adolescents (mean age = 15.17 years, standard deviation = .13; 51.1% male). Allergic disease was a statistically significant risk factor for suicidal ideation (crude odds ratio [COR] = 1.284, 95% confidence interval [CI] = [1.246, 1.323]) and suicide plans (COR = 1.165, 95% CI = [1.108, 1.224]). Short sleep duration was a statistically significant mediator ( p < .001). We advised school nurses to assess warning signs of poor sleep—including irritability, depression, sleep problems, poor concentration, and poor academic achievement—and that programs be created to improve sleep and mental health in adolescents with allergic disease.


2021 ◽  
Vol 12 ◽  
Author(s):  
Zoe Zambelli ◽  
Elizabeth J. Halstead ◽  
Antonio R. Fidalgo ◽  
Dagmara Dimitriou

Individuals with chronic pain often experience co-existing sleep problems and depression-related states. Chronic pain, sleep problems, and depression interrelate, and have been shown to exacerbate one another, which negatively impacts quality of life. This study explored the relationships between pain severity, pain interference, sleep quality, and depression among individuals with chronic pain. Secondly, we tested whether sleep quality may moderate the relationship between pain and depression. A cross-sectional survey was completed by 1,059 adults with non-malignant chronic pain conditions (Mage 43 years, 88% identified as women) and collected measures related to pain severity, pain interference, sleep quality, and depression. Multiple regression analyses found that pain severity, pain interference, and sleep quality are all significantly associated with depression. Secondly, moderated regression analyses revealed that sleep quality moderates the relationship between pain interference and depression among individuals with chronic pain such that good sleep quality attenuates the effect of pain interference on depression, and poor sleep quality amplifies the effect of pain interference on depression. These findings suggest that sleep quality may be a relevant therapeutic target for individuals with chronic pain and co-existing depression.


Author(s):  
İsmail YELPAZE

Prior research indicates that anxiety and emotion regulation are related to sleep quality. This study extends the body of research by investigating how people in different gender groups are affected by the coronavirus disease 2019 (Covid-19) anxiety and emotion regulation in terms of sleep quality. The present study examined gender as a potential moderating variable on the associations of Covid-19 anxiety and emotion regulation with sleep quality. University students were recruited via e-mail to participate in a brief online survey. Data were collected using the Pittsburgh Sleep Quality Index, Fear of COVID-19, and Emotion Management Skills Scale. The current study used SPSS PROCESS, an SPSS macro developed by Hayes. Results indicated that Covid-19 anxiety was related to poor sleep quality and emotion regulation was related to good sleep quality. Gender was a significant moderator for the relationship between Covid-19 anxiety and sleep quality, but not emotion regulation and sleep quality. The female gender presented a positive association between Covid-19 anxiety and poor sleep quality in comparison to the male gender. The relationship between emotion regulation and good sleep quality was found to be significant and positive for both genders. In the pandemic, Covid-19 anxiety should be reduced and people should have skills to manage their emotions. Otherwise, they will experience serious sleep problems.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Cheng-Fang Yen ◽  
Huang-Chi Lin ◽  
Chih-Hung Ko ◽  
Hung-Chi Wu ◽  
Chih-Yao Hsu ◽  
...  

AbstractSleep problems are common in Taiwan. Poor sleep may be associated with many illnesses, including substance use disorders. Ketamine use disorder has significantly increased in Taiwan in recent years and may lead to physical and cognitive problems. Craving for ketamine is a risk factor for ketamine use and relapse, and poor sleep quality may increase craving. This study aimed to explore the mediating effects of craving on the relationship between poor sleep quality and ketamine use. Demographic data, sleep quality, severity of dependence and craving were recorded for current ketamine users and abstinent ketamine users. Mediation analysis was used to examine the mediating effect of craving on the relationship between poor sleep and ketamine use. This study enrolled 414 current ketamine users with ketamine use disorder, 238 current ketamine users without ketamine use disorder, and 102 abstinent ketamine users with ketamine use disorder. Compared with healthy controls, all ketamine users had poor sleep quality. Poor sleep quality was associated with the initiation of and dependence on ketamine use. Craving can mediate the relationship between poor sleep quality and ketamine use. Poor sleep quality remains a problem for those abstaining from ketamine use. Poor sleep quality in ketamine users is an important issue because it is directly and indirectly through craving associated with ketamine use.


Author(s):  
María Dolores Toscano-Hermoso ◽  
Félix Arbinaga ◽  
Eduardo J. Fernández-Ozcorta ◽  
Juan Gómez-Salgado ◽  
Carlos Ruiz-Frutos

Sleep problems in university students are important and have implications for health, quality of life, and academic performance. Using an ex post facto design, a total sample of 855 students (55.7% women) participated in the study. Sleep assessment was conducted using the Pittsburgh Sleep Quality Index, the Nightmare Frequency Scale, the Nightmare Proneness Scale, and the Composite Morningness Scale. Women show a higher risk [OR = 2.61] of presenting poor sleep quality (> 5 points on the PSQI) compared with men (p < 0.001). Similarly, women reported a greater frequency of nightmares (p < 0.001, d = 0.60), greater propensity for nightmares (p < 0.001, d = 0.70) and a higher score on Item-5h of the PSQI regarding nightmares (p < 0.001, d = 0.59). Women, compared with men, show higher risk [OR = 2.84] for a sleep disorder related to nightmares (p = 0.012). Women need more time to reach a state of alertness after getting up (p = 0.022), and there was an interaction between sex and the alertness factor when evaluating the subjective quality of sleep (p = 0.030). Women show worse sleep quality and a higher frequency and propensity for suffering nightmares. When considering the relationship between sleep quality and academic performance, it is observed that students with poor sleep quality obtain lower academic scores (M = 7.21, SD = 0.805) than those with good sleep quality (M = 7.32, SD = 0.685), an effect that reaches significance (t = 2.116, p = 0.035). Regarding the relationship between the categorized chronotype and academic performance, students with a morning chronotype achieve better academic results (M = 7.41, SD = 0.89) than their evening counterparts (M = 7.15, SD = 0.76), although these differences have a small effect size (d = 0.31).


2001 ◽  
Vol 42 (1) ◽  
pp. 21-36 ◽  
Author(s):  
Heather Uncapher

Cognitive factors such as perceptions of poor health and negative expectancies toward the future may mediate relationships between health variables, depressive symptoms, and suicidal ideation. In this study of risk factors associated with late life suicidal ideation, thirty older psychiatric inpatients were interviewed using standardized instruments. Self-reported symptoms of hopelessness, perceived health, and depression, as well as number of impaired medical illness systems were examined in relation to presence of suicidal thoughts. Several aspects of a cognitive model of suicide were supported using partial correlation and regression analyses. First, patients who were more depressed and suicidal had more negative cognitions than those who were less depressed and not suicidal. Second, depressive symptoms were strongly related to suicidal thoughts even after controlling for the patients' number of impaired illness systems. Third, cognitive factors versus health factors were shown to influence the relationship between depression and suicidal ideation. These findings emphasize the importance of cognitive biases in geriatric suicidal ideation.


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