Tubbs Andrew S, Fernandez Fabian-Xosé, Johnson Dayna A, Perlis Michael L, Grandner Michael A
Department of Psychiatry, University of Arizona, Tucson, Arizona.
Corresponding author: Andrew S. Tubbs, BSc, Department of Psychiatry, The University of Arizona, College of Medicine, PO Box 245002, Tucson, AZ, USA 85724-5002 (
J Clin Psychiatry. 2021 Sep 21;82(6):20m13820. doi: 10.4088/JCP.20m13820.
Prior studies indicate nocturnal wakefulness is associated with suicide, while morning wakefulness is linked to reduced suicidal ideation. These relationships, however, may be confounded by sociodemographic factors. Therefore, this study investigated whether timing of wakefulness was associated with suicidal ideation in a nationally representative sample. Data were collected from the US National Health and Nutrition Examination Survey for the years 2015 to 2018, resulting in a final sample of 10,166 participants (51.1% female) with complete data available on suicidal ideation status, time to bed, and time out of bed. Population-weighted logistic regression models estimated the associations between time spent out of bed (ie, being awake) and suicidal ideation. A total of 385 survey participants (47.5% female) reported suicidal ideation in the past 2 weeks for a population-weighted prevalence of 3.37% (95% CI, 2.85%-3.87%). Wakefulness between 11:00 pm and 5:00 am was associated with suicidal ideation (OR = 1.16; 95% CI, 1.08-1.24 per hour), even after adjustment for sociodemographic factors and symptoms of sleep disorders, but not after adjustment for the severity of depression symptoms. Conversely, wakefulness between 5:00 am and 11:00 am was associated with reduced odds of suicidal ideation (OR = 0.77; 95% CI, 0.70-0.85 per hour) in all models. Individuals who spent more time awake at night were more likely to have recent suicidal ideation, while the opposite was true for those with more time spent awake in the morning. Moreover, these associations were independent of sociodemographic factors and thus not confounded by varying rates of suicidal ideation in different populations.
先前的研究表明,夜间觉醒与自杀有关,而早晨觉醒则与自杀意念的减少有关。然而,这些关系可能会受到社会人口学因素的混淆。因此,本研究调查了在一个具有全国代表性的样本中,觉醒时间是否与自杀意念有关。数据收集自2015年至2018年的美国国家健康和营养检查调查,最终样本为10166名参与者(51.1%为女性),他们拥有关于自杀意念状态、上床时间和起床时间的完整数据。人口加权逻辑回归模型估计了起床时间(即清醒时间)与自杀意念之间的关联。共有385名调查参与者(47.5%为女性)报告在过去两周内有自杀意念,人口加权患病率为3.37%(95%CI,2.85%-3.87%)。即使在调整了社会人口学因素和睡眠障碍症状后,晚上11点至凌晨5点之间的觉醒仍与自杀意念有关(OR = 1.16;95%CI,每小时1.08-1.24),但在调整了抑郁症状的严重程度后则不然。相反,在所有模型中,凌晨5点至上午11点之间的觉醒与自杀意念的几率降低有关(OR = 0.77;95%CI,每小时0.70-0.85)。夜间清醒时间较长的个体近期更有可能有自杀意念,而早晨清醒时间较长的个体则相反。此外,这些关联独立于社会人口学因素,因此不会因不同人群中自杀意念发生率的差异而混淆。