Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02215, USA.
National Taiwan University Hospital, 7, Zhongshan S. Rd., Taipei, Taiwan.
Eur Child Adolesc Psychiatry. 2019 May;28(5):635-643. doi: 10.1007/s00787-018-1227-8. Epub 2018 Sep 15.
Suicide is a major threat to adolescent health. Sleep problems increase the risk of adolescent suicidal behavior, but the role of sleep-disordered breathing (e.g., sleep apnea) is unclear. We investigated whether sleep apnea had an effect on suicidal ideation that was independent of depression and perceived stress. We examined a series of sleep variables with suicidal ideation in 746 fifth and seventh graders using self-reported questionnaires to assess time in bed, sleep quality, insomnia, and sleep apnea while controlling depression and perceived stress. Overall, 8.8% of students aged 10-14 years reported having recent suicidal ideation, and 33% or 3.8%, depending on the screening criteria, reported having suspected sleep apnea. The sleep variables were all associated with an increased risk of suicidal ideation, but the magnitude of effects was largely attenuated when depression and perceived stress were included in the models. Suspected sleep apnea using daytime sleepiness as a screening criterion was independently associated with suicidal ideation (odds ratio = 2.25, p < 0.05). Suspected sleep apnea was associated with suicidal ideation that was partly independent of depression and stress, which reveals the pertinence of screening for sleep apnea among school students and designing proper prevention strategies for reducing youth suicidal behavior.
自杀是青少年健康的主要威胁。睡眠问题会增加青少年自杀行为的风险，但睡眠呼吸紊乱（如睡眠呼吸暂停）的作用尚不清楚。我们研究了睡眠呼吸暂停是否会对自杀意念产生影响，而这种影响是否独立于抑郁和感知压力。我们使用自我报告的问卷，对 746 名五年级和七年级学生的一系列睡眠变量与自杀意念进行了调查，以评估睡眠时间、睡眠质量、失眠和睡眠呼吸暂停，同时控制抑郁和感知压力。总的来说，10-14 岁的学生中有 8.8%报告最近有自杀意念，根据筛查标准，33%或 3.8%的学生报告有疑似睡眠呼吸暂停。睡眠变量都与自杀意念的风险增加有关，但当将抑郁和感知压力纳入模型时，影响的幅度在很大程度上减弱了。使用日间嗜睡作为筛查标准的疑似睡眠呼吸暂停与自杀意念独立相关（优势比=2.25，p<0.05）。疑似睡眠呼吸暂停与自杀意念有关，而这种关联在一定程度上独立于抑郁和压力，这表明在学生中筛查睡眠呼吸暂停以及制定适当的预防策略来减少青少年自杀行为具有相关性。
