0696 The Moderating Role of Sleepiness among Intraday Passive and Active Suicidal Ideation

Abstract

Abstract Introduction Disrupted sleep has been linked to suicidal thought and behavior. Less is known regarding underlying mechanisms of this relationship. A more nuanced understanding of the link between sleep and suicide may help inform treatment decisions and the development of prevention and intervention strategies. We examine prior day sleepiness as a moderator to the relationship between passive and active suicidal ideation (SI). Methods Young adults (mean age=21.04; SD=2.22) endorsing SI (n=59) at least twice in the past two weeks were enrolled in a trial examining potential iatrogenic effects of the ecological momentary assessment (EMA) of SI. A baseline battery collected data on past suicidal thought and behavior, demographics, and psychological distress. EMA surveys were administered randomly five times per day over four weeks and assessed sleepiness and current emotional state including occurrence and severity of SI and passive/active ideation. Results Altogether, 835 daily average EMA entries were utilized in the present analysis. A significant relationship (p<.05) was observed between sleepiness and passive SI and its impact on the intensity and duration of SI. Specifically, the association between passive and active SI was stronger on days that participants endorsed greater sleepiness. There was also a significant interaction such that one’s desire to die and a low desire to stay awake significantly interacted (p<.05) to predict same-day perceived controllability of SI. Meaning that when participants had a lower desire to stay awake, there was a stronger relationship among perceived ability to control one’s SI and lower desire to live. Conclusion This study examined the impact of daily sleepiness on relationships among passive and active SI among young adults endorsing suicidal thought. Findings indicate that the relation between daily passive and active SI severity grows stronger the sleepier one is relative to their average level of sleepiness. Future studies should incorporate objective measures of sleep to further explore these findings and clinical implications. Support (if any) This study was funded by the American Psychological Foundation. This work was also supported, in part, by the VA Center of Excellence for Suicide Prevention. Authors’ views do not necessarily represent those of the Department of Veterans Affairs or the United States Government.