Center of Excellence for Suicide Prevention, Canandaigua VAMC, 400 Fort Hill Ave, Canandaigua, NY 14244.
VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, Canandaigua, New York, USA.
J Clin Psychiatry. 2018 Jan/Feb;79(1). doi: 10.4088/JCP.17m11480.
Sleep disturbances have been associated with increased risk for suicidal thought and behavior. The literature in regard to sleep and suicide, however, has focused predominantly on generalized sleep disturbance or insomnia. The purpose of the current study is to examine relationships among sleep apnea and suicidal thought and behavior using a nationally representative sample.
We conducted a secondary analysis of 2014 data from the National Survey on Drug Use and Health. Respondents from a random sample of US households who were 18 years or older (N = 40,149) completed an interview including items assessing past-year sleep apnea, suicidal ideation, suicide planning, and suicide attempt.
Among respondents with sleep apnea (2.9%; n = 1,155), prevalence of suicidality was reported to be 9.7% for suicidal ideation, 3.4% for suicide planning, and 1.0% for suicide attempt compared with 4.9%, 1.4%, and 0.7%, respectively, for those without sleep apnea. Multiple logistic regression analyses revealed that sleep apnea was significantly associated with both suicidal ideation (OR = 1.50; 95% CI, 1.18-1.91) and suicide planning (OR = 1.56; 95% CI, 1.08-2.26) after controlling for age, sex, ethnicity, past-year substance use disorder, self-rated overall health, past-year sedative-hypnotic misuse, past-year depressive episode, heart disease, high blood pressure, stroke, diabetes, and body mass index. Sleep apnea was not significantly associated with report of past-year suicide attempt (OR = 1.22; 95% CI, 0.66-2.26).
Suicidal ideation and suicide planning were more likely to be endorsed by respondents with sleep apnea compared to those without after accounting for key covariates. Diagnosis of sleep apnea may represent an early opportunity for providers to discuss suicide and mental health with their patients.
睡眠障碍与自杀念头和行为的风险增加有关。然而，关于睡眠和自杀的文献主要集中在普遍的睡眠障碍或失眠上。本研究的目的是使用全国代表性样本研究睡眠呼吸暂停与自杀念头和行为之间的关系。
我们对 2014 年国家药物使用和健康调查的数据进行了二次分析。来自美国随机家庭样本的 18 岁或以上的受访者（N=40149）完成了一项访谈，其中包括评估过去一年睡眠呼吸暂停、自杀意念、自杀计划和自杀未遂的项目。
在患有睡眠呼吸暂停的受访者中（2.9%；n=1155），报告自杀意念的发生率为 9.7%，自杀计划的发生率为 3.4%，自杀未遂的发生率为 1.0%，而没有睡眠呼吸暂停的受访者的相应发生率分别为 4.9%、1.4%和 0.7%。多变量逻辑回归分析显示，在控制年龄、性别、种族、过去一年物质使用障碍、自我评估总体健康状况、过去一年镇静催眠药滥用、过去一年抑郁发作、心脏病、高血压、中风、糖尿病和体重指数后，睡眠呼吸暂停与自杀意念（OR=1.50；95%CI，1.18-1.91）和自杀计划（OR=1.56；95%CI，1.08-2.26）显著相关。睡眠呼吸暂停与过去一年自杀未遂的报告无显著相关性（OR=1.22；95%CI，0.66-2.26）。
在考虑了关键协变量后，与没有睡眠呼吸暂停的受访者相比，有睡眠呼吸暂停的受访者更有可能报告自杀意念和自杀计划。诊断睡眠呼吸暂停可能代表着提供者与患者讨论自杀和心理健康的早期机会。
