The link between sleep disturbances and suicidal thoughts and behaviors in remitted bipolar I patients.

OBJECTIVE

We aimed to evaluate the links between different sleep parameters and suicidal ideation and behavior in remitted bipolar I patients.

METHODS

One hundred eight remitted bipolar I patients were recruited from the psychiatry department of Razi Hospital. The third item of the "Hamilton Depression Rating Scale" was used to evaluate current suicidal behaviors. Circadian typology, daytime sleepiness and sleep quality were evaluated using the "Horne and Ostberg Morningness-Eveningness Questionnaire," the "Epworth Sleepiness Scale," and the "Pittsburgh Sleep Quality Index," respectively.

RESULTS

Current suicidal ideation and behavior were significantly associated with circadian typology, daytime sleepiness, and sleep quality. After controlling for demographic variables (age and gender) and psychosocial factors (depression and substance use), suicidal ideation significantly contributed to sleep quality. Depression was a significant predictor within the second step when entered with other psychosocial variables; however, once suicide variables were included, depression was no longer a significant predictor.

CONCLUSIONS

An evaluation of sleep's quality should be included in the suicide risk assessment of bipolar I patients.