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Suicidal ideation and suicide attempts: associations with sleep duration, insomnia, and inflammation

Published online by Cambridge University Press:  23 April 2020

Emily A. Dolsen Open the ORCID record for Emily A. Dolsen [Opens in a new window] ,
Aric A. Prather ,
Femke Lamers  and
Brenda W. J. H. Penninx
Emily A. Dolsen*
Affiliation:
Department of Psychology, University of California, Berkeley, 2121 Berkeley Way, Berkeley, CA94720, USA
Aric A. Prather
Affiliation:
Department of Psychiatry, University of California San Francisco, San Francisco, CA94118, USA
Femke Lamers
Affiliation:
Department of Psychiatry, Amsterdam Neuroscience and Amsterdam Public Health Research Institutes, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
Brenda W. J. H. Penninx
Affiliation:
Department of Psychiatry, Amsterdam Neuroscience and Amsterdam Public Health Research Institutes, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
*
Author for correspondence: Emily A. Dolsen, E-mail: emily.dolsen@ucsf.edu
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Abstract

Background

Sleep disturbance has been consistently identified as an independent contributor to suicide risk. Inflammation has emerged as a potential mechanism linked to both sleep disturbance and suicide risk. This study tested associations between sleep duration, insomnia, and inflammation on suicidal ideation (SI) and history of a suicide attempt (SA).

Methods

Participants included 2329 adults with current or remitted depression and/or anxiety enrolled in the Netherlands Study of Depression and Anxiety. Sleep duration, insomnia, past week SI, and SA were assessed with self-report measures. Plasma levels of C-reactive protein, interleukin-6, and tumor necrosis factor-α were obtained.

Results

Short sleep duration (⩽6 h) compared to normal sleep duration (7–9 h) was associated with reporting a prior SA, adjusting for covariates [adjusted odds ratio (AOR) 1.68, 95% CI 1.13–2.51]. A higher likelihood of SI during the past week was observed for participants with long sleep duration (⩾10 h) compared to normal sleep duration (AOR 2.22, 95% CI 1.02–4.82), more insomnia symptoms (AOR 1.44, 95% CI 1.14–1.83), and higher IL-6 (AOR 1.31, 95% CI 1.02–1.68). Mediation analyses indicated that the association between long sleep duration and SI was partially explained by IL-6 (AOR 1.02, 95% CI 1.00–1.05).

Conclusions

These findings from a large sample of adults with depression and/or anxiety provide evidence that both short and long sleep duration, insomnia symptoms, and IL-6 are associated with the indicators of suicide risk. Furthermore, the association between long sleep duration and SI may operate through IL-6.

Keywords

Anxietydepressioninflammationinsomniasleepsuicide
Type
Original Article
Information
Psychological Medicine , Volume 51 , Issue 12 , September 2021 , pp. 2094 - 2103
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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Footnotes

*

Article last updated 18 January 2022.

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