Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL, 32306-4301, USA.
Sci Rep. 2020 Aug 17;10(1):13888. doi: 10.1038/s41598-020-70866-6.
In recent years, there has been a growing interest in understanding the relationship between sleep and suicide. Although sleep disturbances are commonly cited as critical risk factors for suicidal thoughts and behaviours, it is unclear to what degree sleep disturbances confer risk for suicide. The aim of this meta-analysis was to clarify the extent to which sleep disturbances serve as risk factors (i.e., longitudinal correlates) for suicidal thoughts and behaviours. Our analyses included 156 total effects drawn from 42 studies published between 1982 and 2019. We used a random effects model to analyse the overall effects of sleep disturbances on suicidal ideation, attempts, and death. We additionally explored potential moderators of these associations. Our results indicated that sleep disturbances are statistically significant, yet weak, risk factors for suicidal thoughts and behaviours. The strongest associations were found for insomnia, which significantly predicted suicide ideation (OR 2.10 [95% CI 1.83-2.41]), and nightmares, which significantly predicted suicide attempt (OR 1.81 [95% CI 1.12-2.92]). Given the low base rate of suicidal behaviours, our findings raise questions about the practicality of relying on sleep disturbances as warning signs for imminent suicide risk. Future research is necessary to uncover the causal mechanisms underlying the relationship between sleep disturbances and suicide.
近年来，人们越来越关注睡眠与自杀之间的关系。虽然睡眠障碍通常被认为是自杀想法和行为的关键风险因素，但睡眠障碍对自杀风险的影响程度尚不清楚。本荟萃分析旨在阐明睡眠障碍在多大程度上是自杀想法和行为的风险因素（即纵向相关因素）。我们的分析包括 1982 年至 2019 年期间发表的 42 项研究中得出的 156 项总效应。我们使用随机效应模型分析了睡眠障碍对自杀意念、自杀企图和自杀死亡的总体影响。我们还探讨了这些关联的潜在调节因素。我们的结果表明，睡眠障碍是自杀想法和行为的统计学上显著但较弱的风险因素。与失眠的关联最强，失眠显著预测自杀意念（OR 2.10 [95% CI 1.83-2.41]），噩梦显著预测自杀企图（OR 1.81 [95% CI 1.12-2.92]）。鉴于自杀行为的低基础发生率，我们的发现引发了关于将睡眠障碍作为即将发生自杀风险的预警信号的实用性问题。未来的研究需要揭示睡眠障碍与自杀之间关系的因果机制。
