Young Adults With Sleep Disturbance Show Increased Risk for Suicidal Ideation

Young adults who experience sleep disturbances, such as nightmares, sleep onset latency, and sleep quality, may also experience passive suicidal ideation, according to study findings published in the journal Psychiatry Research.

Suicide is the second leading cause of death in young adults, but predictors for increased suicide risk have not been identified. Sleep disturbance is a “promising modifiable risk factor for acute changes in suicide risk,” according to researchers. Previous research has found variables of sleep disturbance are associated with higher suicidal ideation, including “insomnia symptoms, both short and long sleep duration, nocturnal wakefulness, and nightmares.” However, data on the effect of sleep disturbance on suicide risk are limited.

Researchers conducted a longitudinal study on a cohort of 102 young adults aged 18-35 (74.5% women; 64.7% White) who had a history of suicidal behavior, examining the correlation between their self-reported wake and sleep schedules over a period of 21 days and the associated risk for suicide and suicidal ideation.

Participants shared their experiences of suicidal thoughts using 2 yes/no questions based on the Columbia Suicide Severity Rating Scale. This assessment included passive ideation, and the researchers also analyzed data that considered both within-person changes and between-person differences with sleep variables including bedtime, sleep onset latency, sleep onset, number of awakenings, wake after sleep onset, sleep duration, sleep timing, sleep quality, and nightmares.

Estimates were presented as standardized mean estimates, standard deviations, and 95% credibility intervals.

The researchers also conducted exploratory analyses to examine the bidirectional effects of daily passive and active suicidal thoughts on sleep disturbances in subsequent nights, while controlling for the previous night’s sleep disturbance.

Daily variations in sleep onset latency did not significantly impact the likelihood of experiencing passive or active suicidal ideation the next day at the within-person level. However, at the between-person level, longer sleep onset latency was associated with a higher likelihood of experiencing both passive and active suicidal ideation.

At the within-person level, increased wakefulness between sleep onset and sleep offset on certain nights was associated with a higher likelihood of experiencing passive and active suicidal ideation the following day, while no significant effects of wake after sleep onset were observed at the between-person level.

At both the within-person level and between-person level, neither the duration nor the timing of sleep demonstrated any significant effects on passive or active suicidal ideation.

Poor sleep quality was associated with increased chances of both passive and active suicidal thoughts at the within-person level, particularly on days when sleep quality was worse than usual for the person.

Moreover, participants with lower average sleep quality were more prone to experiencing passive suicidal thoughts during the study period. However, no significant effects of sleep quality on active suicidal thoughts were found at the between-person level.

Participants who experienced more frequent nightmares were found to have a higher chance of passive suicidal ideation. This association was observed both at the within-person level on days with an increased number of nightmares and at the between-person level among individuals who typically had more nightmares.

However, there were no significant effects of nightmares on active suicidal thoughts, either individually or within the group.

“These findings disentangle within- and between-person effects and provide evidence for daily intraindividual associations between multiple sleep disturbance components and near-term increases in passive and active SI [suicidal ideation],” the researchers stated.

They concluded, “This research may necessitate higher risk samples and study designs that involve EMA [ecological momentary assessment] bursts over longer-term follow-up periods to capture suicidal behaviors,” the researchers stated. However, they acknowledged, it is the first study to provide evidence for the role of daily sleep disturbance as a near-term predictor for suicidal ideation in young adults.

This study may be limited by researchers not investigating more severe levels of suicidal ideation and behaviors, as they were rarely reported during the study.