Muroi Kei, Ishitsuka Mami, Hori Daisuke, Doki Shotaro, Ikeda Tomohiko, Takahashi Tsukasa, Sasahara Shinichiro, Matsuzaki Ichiyo
University of Tsukuba, Tsukuba, Japan.
Health Psychol Rep. 2023 Jun 26;11(4):309-320. doi: 10.5114/hpr/163068. eCollection 2023.
The present study aimed to investigate whether insomnia is associated with suicidal ideation (SI) among Japanese workers by conducting a multi-level analysis with sense of coherence (SOC) as a random effect.
A cross-sectional survey was conducted among 19,481 workers in Tsukuba, Japan. Data from 7,175 participants aged 20-65 years were included in the analysis. The Athens Insomnia Scale (AIS) was used as the independent variable, and SI over the past year was used as the dependent variable. SOC was measured using the five-point SOC-13 scale, and socioeconomic and health factors were investigated as covariates. Participants were divided into three groups (low, medium, and high) based on their SOC scores. Multilevel logistic regression analysis was performed to calculate odds ratios (OR) and 95% confidence intervals (95% CI).
In the high-SOC group, only one person had SI. In a multi-level logistic analysis that excluded the high SOC group, insomnia was found to be associated with SI (OR = 2.26, 95% CI [1.75, 2.93]). Furthermore, the AIS sub-items "Final awakening earlier than desired" (OR = 1.26, 95% CI [1.05, 1.50]) and "Sense of well-being during the day" (OR = 1.63, 95% CI [1.34, 1.99]) were associated with SI. 8.95% or 11% of the variation in the presence or absence of SI was found to be explained by differences between SOC groups.
The study highlights that insomnia is associated with SI, and that high SOC may reduce SI even under insomnia. Future longitudinal studies are needed to confirm whether high SOC reduces SI due to insomnia.
本研究旨在通过以连贯感（SOC）作为随机效应进行多层次分析，探讨日本工人中失眠与自杀意念（SI）之间是否存在关联。
在日本筑波的19481名工人中进行了横断面调查。分析纳入了7175名年龄在20 - 65岁之间的参与者的数据。使用雅典失眠量表（AIS）作为自变量，过去一年中的自杀意念作为因变量。使用五点SOC - 13量表测量连贯感，并将社会经济和健康因素作为协变量进行调查。参与者根据其SOC得分分为三组（低、中、高）。进行多层次逻辑回归分析以计算优势比（OR）和95%置信区间（95%CI）。
在高SOC组中，只有一人有自杀意念。在排除高SOC组的多层次逻辑分析中，发现失眠与自杀意念相关（OR = 2.26，95%CI [1.75, 2.93]）。此外，AIS子项目“比期望更早最终醒来”（OR = 1.26，95%CI [1.05, 1.50]）和“白天的幸福感”（OR = 1.63，95%CI [1.34, 1.99]）与自杀意念相关。发现自杀意念存在与否的8.95%或11%的变异可由SOC组之间的差异解释。
该研究强调失眠与自杀意念相关，并且即使在失眠情况下，高连贯感也可能降低自杀意念。未来需要进行纵向研究以确认高连贯感是否会降低因失眠导致的自杀意念。
