Sleep duration and suicidal behavior: A systematic review

Abstract

IntroductionSuicide is a serious public health problem, being the second leading cause of death among 15–29-year-olds. Many risk factors have been associated with suicidal behavior, such as psychiatric disorders, family history of suicide, loss of a close friend/relative, physical/sexual abuse, lack of support network, or sleep disturbances where nightmares and insomnia have been consistently reported to increase the risk of suicidal behaviors.ObjectiveTo conduct a systematic review to examine the association between short sleep duration and suicidal behaviour (suicide ideation/attempt/suicide).MethodsThis is a systematic review of published research articles in the electronic database PubMed in the last 10 years. The query “sleep” or “sleep disorders” and “suicide” was used. Studies that assessed the relation between sleep duration and suicidal behaviour, with a well-defined index for sleep disorders and with an outcome measure of suicidal behavior were included.ResultsOf the 522 references founded, 33 articles met the inclusion criteria (1 review, 1 qualitative and 31 quantitative studies). An association between short sleep duration and suicidal behaviour was found in most of the studies with children/adolescents and adult samples. However, this relation was not verified in the research into the elderly.ConclusionThe results point to a significant association between short sleep time and the presence of suicidal behaviours, for both adults and children/adolescents. The effect of short sleep duration seems to be more consistent with suicidal ideation, but not for attempts, needing further studies to highlight the importance of this link between sleep duration and suicide.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The 6/24 rule: A review and proposal for an international standard of a minimum of six hours of continuous sleep in detention settings

“…An International Consensus promoted by the US National Sleep Foundation (Hirshkowitz et al, 2015;Watson, Badr, Belenk, & Bliwise, 2015) agreed that a healthy normal sleep pattern for an adult should include a minimum of 7 (+/-1) hours of daily continuous sleep 1 reviews and meta-analyses of international cohort and longitudinal studies have also consistently shown that mortality is significantly increased in persons sleeping less than 6 (Åkerstedt et al, 2017) to 7 hours per day (Cappuccio, D'Elia, Strazzullo, & Miller, 2010;Yin, J., Jin, X., Shan, Z., Li, S., Huang, H., Li, P. & Liu, L , 2017). This is due to both metabolic changes that increase the risk of death-related diseases (Trivedi, Holger, Bui, Craddock, & Tartar, 2017) and a significantly higher rate of suicide in the affected persons (Pereira, Martins, & Fernandes, 2017). In their international study of reference to date on normal patterns of sleep across a lifespan, Ohayon, Carskadon, Guilleminault, & Vitiello (2004) developed a comprehensive meta-analysis based on 65 studies, which found that sleep duration only slightly decreased around one hour from adult to old age in healthy individuals.…”

Glial Markers of Suicidal Behavior in the Human Brain—A Systematic Review of Postmortem Studies

“…We reported that the polymorphism of CX3CR1 is also related to the blood volume of the human brain [21]. Recent transcriptomic and metaanalyses have shown that altered transcription is associated with astrocytes and is dysregulated in suicidal behavior, mostly downregulated with pathways of protein translation, RNA metabolism [8], and GABAergic and glutamatergic neurotransmitters that may alter neuronal morphology [96]. Oligodendrocytes are crucial in the formation of the neurocircuitry for cognitive function, and their malfunction is reported to be associated with reduced myelin and oxidative stress deficiencies in depressed suicides [60].…”

“…Moreover, suicide is well known and associated with early adverse childhood experiences as well as adverse life events [38]. Proteomic and metabolomic studies of periphery blood indicated that inflammatory metabolism and imbalanced lipid transport are also associated with suicide behavior [96]. Together, suicide is a complex behavior that is rarely the outcome of a single factor, especially the molecular changes in glial cells.…”