Zhang Yunshu, Liu Bo, Li Keqing, Jia Hailing, Shi Hemin, Liu Yongqiao, Li Jianfeng, Sun Long
Hebei Provincial Mental Health Center, Baoding, Hebei Province, China.
The Sixth Clinical Medical College of Hebei University, Baoding, Hebei Province,, China.
BMC Public Health. 2025 Jan 17;25(1):199. doi: 10.1186/s12889-025-21443-x.
Previous studies have yielded conflicting findings regarding the relationship between the use of sleep-related drugs (SRDU) and suicidal behaviors. This population-based study aimed to analyze the associations between SRDU and suicidal behaviors. Additionally, we examined the associations between SRDU and specific conditional suicidal behaviors, providing insights into the impact of SRDU on the progression of suicidal behaviors.
The study was conducted among community residents aged 18 and older using a cross-sectional design, analyzing 21,376 participants. Data on SRDU, suicidal ideation, plans, and attempts were collected. Participants were categorized into general individuals without suicidal behaviors (GNS), suicidal ideators without a plan or attempt (SINPA), suicidal ideators with a plan but no attempt (SIP), and individuals who attempted suicide (SA). Insomnia, sleep apnea, rapid eye movement sleep behavior disorder (RBD), and narcolepsy were assessed using the Athens Insomnia Scale, Berlin Questionnaire, Rapid Eye Movement Sleep Behavior Disorder Questionnaire, and Ullanlinna Narcolepsy Scale, respectively.
After adjusting for sociodemographic variables, insomnia, sleep apnea, RBD, and narcolepsy, SRDU showed a positive association with suicidal ideation (OR = 3.02), plans (OR = 4.78), and attempts (OR = 6.40; all p < 0.001). Compared to GNS, and after controlling for the same variables, SRDU was associated with SINPA (OR = 2.46), SIP (OR = 5.11), and SA (OR = 6.93; all p < 0.001) respectively. However, no significant differences in SRDU were found between SINPA, SIP, and SA (all p > 0.05).
This population-based study confirms that SRDU is positively associated with suicidal ideation, plans, and attempts, even after accounting for the risk factors of insomnia, sleep apnea, RBD, and narcolepsy. Nonetheless, SRDU does not appear to influence the progression from suicidal ideation to attempt.
先前的研究在使用与睡眠相关药物（SRDU）和自杀行为之间的关系上得出了相互矛盾的结果。这项基于人群的研究旨在分析SRDU与自杀行为之间的关联。此外，我们还研究了SRDU与特定条件下自杀行为之间的关联，以深入了解SRDU对自杀行为进展的影响。
本研究采用横断面设计，对18岁及以上的社区居民进行调查，分析了21376名参与者。收集了关于SRDU、自杀意念、计划和未遂情况的数据。参与者被分为无自杀行为的普通个体（GNS）、有自杀意念但无计划或未遂的个体（SINPA）、有自杀计划但未实施的个体（SIP）以及自杀未遂个体（SA）。分别使用雅典失眠量表、柏林问卷、快速眼动睡眠行为障碍问卷和乌兰卡宁那发作性睡病量表评估失眠、睡眠呼吸暂停、快速眼动睡眠行为障碍（RBD）和发作性睡病。
在对社会人口统计学变量、失眠、睡眠呼吸暂停、RBD和发作性睡病进行调整后，SRDU与自杀意念（OR = 3.02）、计划（OR = 4.78）和未遂情况（OR = 6.40；所有p < 0.001）呈正相关。与GNS相比，在控制相同变量后，SRDU分别与SINPA（OR = 2.46）、SIP（OR = 5.11）和SA（OR = 6.93；所有p < 0.001）相关。然而，在SINPA、SIP和SA之间，SRDU没有显著差异（所有p > 0.05）。
这项基于人群的研究证实，即使在考虑了失眠、睡眠呼吸暂停、RBD和发作性睡病等危险因素后，SRDU与自杀意念、计划和未遂情况仍呈正相关。尽管如此，SRDU似乎并未影响从自杀意念到未遂的进展。
