Bozzay Melanie L, Armey Michael F, Brick Leslie, Nugent Nicole, Huang Jeff, Goldschmidt Andrea B, Schatten Heather T, Primack Jennifer M, Saletin Jared M
Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Sleep Adv. 2025 Feb 12;6(2):zpaf008. doi: 10.1093/sleepadvances/zpaf008. eCollection 2025 Apr.
Diminished sleep health is a known warning sign for suicide. However, the contexts and time periods within which diminished sleep elevates suicide risk are unknown. Modeling the complex process by which diminished sleep health impacts daily functioning and establishing proximal suicide risk factors can aid in addressing these important knowledge gaps. This paper describes the methods and research protocol for a study that aims to elucidate the nature of the sleep-suicide relationship and develop an integrated model of proximal suicide risk. Participants will be 200 adults at high risk for suicide recruited from a psychiatric inpatient unit. They will complete a baseline assessment including clinical interviews and self-reports, and laboratory tasks with concurrent electroencephalography to phenotype-relevant risk processes. This baseline assessment will be followed by 4 weeks of ecological momentary assessment and digital phenotyping, coupled with assessments of sleep via a wearable used to generate a minute-by-minute metric of cognitive effectiveness using the Sleep Activity, Fatigue, and Task Effectiveness algorithm index. Follow-up assessments will be conducted 1-, 3-, and 6-months post-hospital discharge to determine how the developed proximal model of risk prospectively predicts suicidal ideation and behavior. The results of this study have the potential to greatly enhance understanding of how and why diminished sleep health is related to real-world fluctuations in suicide risk, knowledge that can inform efforts to better prevent, and intervene to reduce suicides.
睡眠健康状况不佳是自杀的一个已知警示信号。然而，睡眠质量下降会增加自杀风险的具体背景和时间段尚不清楚。对睡眠健康状况不佳影响日常功能的复杂过程进行建模，并确定近端自杀风险因素，有助于填补这些重要的知识空白。本文描述了一项研究的方法和研究方案，该研究旨在阐明睡眠与自杀关系的本质，并建立一个近端自杀风险的综合模型。研究对象将是从精神科住院部招募的200名有自杀高风险的成年人。他们将完成包括临床访谈和自我报告在内的基线评估，以及同时进行脑电图的实验室任务，以对与表型相关的风险过程进行评估。在这个基线评估之后，将进行为期4周的生态瞬时评估和数字表型分析，同时通过可穿戴设备评估睡眠情况，该设备使用睡眠活动、疲劳和任务效率算法指数来生成每分钟的认知效能指标。出院后1个月、3个月和6个月将进行随访评估，以确定所建立的近端风险模型如何前瞻性地预测自杀意念和行为。这项研究的结果有可能极大地增进人们对睡眠健康状况不佳如何以及为何与自杀风险的现实波动相关的理解，这些知识可为更好地预防和干预自杀的努力提供信息。
