The Menninger Clinic, Houston, TX, USA.
Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
Behav Sleep Med. 2023 Mar-Apr;21(2):129-141. doi: 10.1080/15402002.2022.2050724. Epub 2022 Mar 17.
As sleep problems have been identified as an important, yet understudied, predictor of suicide risk, the present study analyzed the relationship between daytime sleepiness and nighttime sleep disturbance in a high-risk population of adults admitted to an inpatient psychiatric hospital. Objectives were to (1) examine the time course of subjective daytime sleepiness, nighttime sleep disturbance, and suicide risk throughout inpatient psychiatric treatment, (2) examine pre- to post-treatment changes in sleep disturbance with treatment as usual in an inpatient psychiatric setting, and (3) investigate whether daytime sleepiness and nighttime sleep disturbance predicted suicide risk above and beyond anxiety and depression. Participants were 500 consecutively admitted adults admitted to an intermediate length of stay (4-6 weeks) inpatient psychiatric hospital (47% female; 18-87 years of age). Measures of sleep, suicide risk, depression, and anxiety were completed at admission, weeks 1 through 4, and at discharge. Latent growth curve modeling (LGM) and hierarchal linear modeling (HLM) were conducted. The LGM analysis demonstrated that daytime sleepiness, nighttime sleep disturbance, and suicide risk all improved throughout inpatient treatment. Further, HLM showed that daytime sleepiness predicted suicide risk above and beyond symptoms of anxiety, depression, major sleep medications, and prior suicidal ideation and attempts, while nighttime sleep disturbance predicted suicide risk above and beyond symptoms of anxiety, major sleep medications, and prior suicidal ideation and attempts. Findings indicate the need to reevaluate safety protocols that may impact sleep, particularly that may increase daytime sleepiness, and to develop evidence-based sleep interventions for individuals admitted to inpatient psychiatric hospitals.
由于睡眠问题已被确定为自杀风险的一个重要但研究不足的预测因素，本研究分析了在入住精神病院的高风险成年人人群中，日间嗜睡与夜间睡眠障碍之间的关系。目的是：(1) 考察主观日间嗜睡、夜间睡眠障碍和自杀风险在精神病住院治疗期间的时间进程；(2) 考察在精神病住院环境中，常规治疗下睡眠障碍的治疗前至治疗后变化；(3) 调查日间嗜睡和夜间睡眠障碍是否在焦虑和抑郁之外预测自杀风险。参与者为 500 名连续入住中等住院时间（4-6 周）精神病院的成年人（47%为女性；年龄 18-87 岁）。在入院时、第 1 周到第 4 周以及出院时完成了睡眠、自杀风险、抑郁和焦虑的测量。进行了潜在增长曲线建模（LGM）和层次线性建模（HLM）。LGM 分析表明，日间嗜睡、夜间睡眠障碍和自杀风险在住院治疗期间均有所改善。此外，HLM 显示，日间嗜睡预测自杀风险的能力超过了焦虑、抑郁、主要睡眠药物和既往自杀意念和尝试，而夜间睡眠障碍预测自杀风险的能力超过了焦虑、主要睡眠药物和既往自杀意念和尝试。研究结果表明，需要重新评估可能影响睡眠的安全协议，特别是可能增加日间嗜睡的协议，并为入住精神病院的个体制定基于证据的睡眠干预措施。
