Department of Clinical Psychology, Institute of Psychology, Leiden University, the Netherlands.
Department of Clinical Psychology, Institute of Psychology, Leiden University, the Netherlands; Leiden University Treatment and Expertise Center (LUBEC), Leiden, the Netherlands.
J Psychiatr Res. 2024 Sep;177:46-52. doi: 10.1016/j.jpsychires.2024.06.039. Epub 2024 Jun 26.
Recent research shows that sleep disturbances are linked to increased suicidal ideation. In the present longitudinal cohort study, we used subjective (ecological momentary assessment, EMA) and objective (actigraphy) measures to examine the effects of sleep parameters on next-day suicidal ideation. Further, we examined hopelessness as a mediator between insufficient sleep and increased suicidal ideation. Individuals with current suicidal ideation (N = 82) completed 21 days of EMA and actigraphy to estimate suicidal ideation, hopelessness and sleep parameters. Multilevel linear-mixed models were used to examine the effects of sleep parameters on next-day suicidal ideation, as well as for the mediating effect of hopelessness (in the morning) on the association between previous night's sleep and suicidal ideation levels the next day. Significant concordance existed between subjective and objective sleep measures, with moderate-to-large correlations (r = 0.44-0.58). Lower subjective sleep quality and efficiency, shorter total sleep time and increased time awake after sleep onset were significantly associated with increased next-day suicidal ideation (controlling for previous-day suicidal ideation). Actigraphy-measured sleep fragmentation was also a significant predictor of next-day ideation. Hopelessness mediated the effects of the subjective sleep parameters on suicidal ideation, but did not account for the association with sleep fragmentation. Therefore, individuals' psychological complaints (hopelessness, suicidal ideation) were better predicted by subjective sleep complaints than by objective sleep indices. Increased hopelessness following from perceived insufficient sleep appears an important explanatory factor when considering the link between sleep disturbances and suicidal ideation.
最近的研究表明，睡眠障碍与自杀意念增加有关。在本纵向队列研究中，我们使用主观（生态瞬时评估，EMA）和客观（活动记录仪）测量来检查睡眠参数对次日自杀意念的影响。此外，我们还研究了绝望感在睡眠不足与自杀意念增加之间的中介作用。当前有自杀意念的个体（N=82）完成了 21 天的 EMA 和活动记录仪，以评估自杀意念、绝望感和睡眠参数。多级线性混合模型用于检查睡眠参数对次日自杀意念的影响，以及绝望感（早晨）在先前夜晚睡眠与次日自杀意念水平之间的关联中的中介作用。主观和客观睡眠测量之间存在显著的一致性，中等至较大的相关性（r=0.44-0.58）。主观睡眠质量和效率降低、总睡眠时间缩短以及入睡后醒来时间增加与次日自杀意念增加显著相关（控制前一天自杀意念）。活动记录仪测量的睡眠片段化也是次日意念的重要预测指标。绝望感中介了主观睡眠参数对自杀意念的影响，但与睡眠片段化无关。因此，与客观睡眠指数相比，个体的心理抱怨（绝望感、自杀意念）通过主观睡眠抱怨得到了更好的预测。从感知到的睡眠不足中产生的更高的绝望感似乎是考虑睡眠障碍与自杀意念之间联系的一个重要解释因素。
