Abstract
BackgroundSleep disturbances are an underestimated risk factor for suicidal ideation and behavior. Previous research provided preliminary support of a temporal relationship between sleep disturbances and suicidal ideation. The present study therefore sought to investigate the prospective association between sleep disturbances, passive and active suicidal ideation, and further psychological risk factors, such as state impulsivity and depression.MethodsSeventy-three psychiatric inpatients (71% female) with unipolar depressive disorder and current or lifetime suicidal ideation took part in an ecological momentary assessment (EMA). Participants filled out a baseline assessment and data were collected via smartphones over a 6-days period. Multilevel analyses with sleep disturbance as predictor for active and passive suicidal ideation, state impulsivity, and depression were carried out.ResultsPatients with sleep disturbance experienced more active suicidal ideation, but no passive suicidal ideation, the following day. Of the four state impulsivity items, one item was significantly associated with sleep disturbance. Sleep disturbance had no effect on next-day depression. Limiting factors are the small and homogeneous sample along with the rather short observation period in an inpatient setting.ConclusionsThe micro-longitudinal study provides preliminary support for sleep disturbance as a proximal risk factor for next-day active suicidal ideation. Clinically, results indicate to consider the evaluation and treatment of sleep disturbances for an improved risk assessment and prevention of suicide.
Highlights
Suicide represents a major public health problem and accounts for 1.4% of all deaths globally
In a state of ego depletion, people behave more impulsively and aggressively due to a lack of self-regulation resources [8]. This sleep-loss related impulsive behavior to negative emotional stimuli and an increased aggressive behavior observed for short sleepers might be an explanation for the link between sleep disturbances and increased suicide ideation and behavior, since a reduced impulse control is correlated with suicidal behavior [9]
Sleep disturbances had no effect on depression;
Summary
Suicide represents a major public health problem and accounts for 1.4% of all deaths globally. People who were sleep-deprived showed a reduced response inhibition to negative emotional stimuli during an emotional Go/No-Go Task [7] This effect is known as ego depletion [8]. In a state of ego depletion, people behave more impulsively and aggressively due to a lack of self-regulation resources [8]. This sleep-loss related impulsive behavior to negative emotional stimuli and an increased aggressive behavior observed for short sleepers might be an explanation for the link between sleep disturbances and increased suicide ideation and behavior, since a reduced impulse control is correlated with suicidal behavior [9]. The present study sought to investigate the prospective association between sleep disturbances, passive and active suicidal ideation, and further psychological risk factors, such as state impulsivity and depression
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