Chakravorty Subhajit, Siu H Y Katy, Lalley-Chareczko Linden, Brown Gregory K, Findley James C, Perlis Michael L, Grandner Michael A
Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Prim Care Companion CNS Disord. 2015 Dec 31;17(6). doi: 10.4088/PCC.13m01551. eCollection 2015.
Suicidal behavior (suicidal ideation, suicide attempts, and suicide completion) has been increasingly linked with difficulty initiating sleep, maintaining sleep, and early morning awakenings. However, the relationship between suicidal behavior and sleep duration abnormalities is unclear, especially at the population level. The present study used a nationally representative sample to examine the association of suicidal ideation with extreme sleep durations and insomnia symptoms.
Cross-sectional data from adult respondents (≥ 18 years of age, N = 6,228) were extracted from the 2007-2008 wave of the National Health and Nutritional Examination Survey. Ordinal logistic regression analyses were used to evaluate the relationship of suicidal ideation with sleep duration, global insomnia, and individual insomnia symptoms in models adjusted for sociodemographic, socioeconomic, and health-related covariates.
Suicidal ideation was associated with abnormalities of sleep duration. This relationship ceased to exist once the model was adjusted for depressive symptoms. As expected, an increased level of suicidal ideation was consistently associated with insomnia. Of the insomnia symptoms, difficulty maintaining sleep was found to be the most predictive of suicidal ideation, followed by difficulty initiating sleep (P< .05).
Abnormalities of sleep duration and continuity should prompt a clinical assessment for suicide risk.
自杀行为（自杀意念、自杀未遂和自杀死亡）与入睡困难、睡眠维持困难及早醒的关联日益密切。然而，自杀行为与睡眠时间异常之间的关系尚不清楚，尤其是在总体人群层面。本研究采用具有全国代表性的样本，来探究自杀意念与极端睡眠时间及失眠症状之间的关联。
从2007 - 2008年全国健康与营养检查调查中提取成年受访者（≥18岁，N = 6228）的横断面数据。采用有序逻辑回归分析，在对社会人口学、社会经济和健康相关协变量进行校正的模型中，评估自杀意念与睡眠时间、总体失眠及个体失眠症状之间的关系。
自杀意念与睡眠时间异常有关。一旦模型对抑郁症状进行校正，这种关系就不再存在。正如预期的那样，自杀意念水平的升高始终与失眠有关。在失眠症状中，发现睡眠维持困难最能预测自杀意念，其次是入睡困难（P < .05）。
睡眠时间和连续性异常应促使对自杀风险进行临床评估。
