Suicidal ideation is associated with nighttime wakefulness in a community sample

Abstract

<jats:title>ABSTRACT</jats:title> <jats:sec> <jats:title>Study Objectives</jats:title> <jats:p>Nocturnal wakefulness is a risk factor for suicide and suicidal ideation in clinical populations. However, these results have not been demonstrated in general community samples or compared to sleep duration or sleep quality. The present study explored how the timing of wakefulness was associated with suicidal ideation for weekdays and weekends.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Data were collected from N=888 adults aged 22 to 60 as part of the Sleep and Healthy Activity, Diet, Environment, and Socialization study. Suicidal ideation was measured by the Patient Health Questionnaire – 9, while timing of wakefulness was estimated from the Sleep Timing Questionnaire. Binomial logistic regressions estimated the association between nocturnal (11pm-5am) and morning (5am-11am) wakefulness and suicidal ideation.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Nocturnal wakefulness was positively associated with suicidal ideation on weekdays (OR: 1.44 [1.28-1.64] per hour awake between 23:00 to 05:00, p&amp;lt;0.0001) and weekends (OR: 1.22 [1.08-1.39], p=0.0018). Morning wakefulness was negatively associated with suicidal ideation on weekdays (OR: 0.82 [0.72-0.92] per hour awake between 05:00 to 11:00, p=0.0008) and weekends (OR: 0.84 [0.75-0.94], p=0.0035). These associations remained significant when adjusting for sociodemographic factors. Additionally, nocturnal wakefulness on weekdays was associated with suicidal ideation when accounting for insomnia, sleep duration, sleep quality, and chronotype (OR 1.25 [1.09-1.44] per hour awake, p=0.002).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Wakefulness at night was consistently associated with suicidal ideation. Additionally, morning wakefulness was negatively associated with suicidal ideation in some models. Although these findings are drawn from a non-clinical sample, larger longitudinal studies in the general population are needed to confirm these results.</jats:p> </jats:sec>

Time-of-Day Variation in Subjective Mood Among Lumosity Users

“…These patterns—and their approximate timing—bear strong similarities to those documented during in-lab circadian and sleep deprivation experiments (e.g., Emens et al, 2020). The overnight peak in negative affect is of clinical interest because it may be one of several factors contributing to the higher risk of suicide during the circadian night (Tubbs et al, 2020b; Tubbs et al, 2021a; Tubbs et al, 2021b). It is possible that people who are awake in the middle of the night experience the full brunt of the peak in negative affect at a time when most are shielded from it because they are sleeping (Emens et al, 2020).…”

Suicidal Ideation Is Associated With Excessive Smartphone Use Among Chinese College Students

“…If the answer was "Yes, " the student was considered as experiencing suicidal ideation in the past year. Similar methodology has been followed in previous studies on suicidal ideation (13,21,34,35).…”

The Mind After Midnight: Nocturnal Wakefulness, Behavioral Dysregulation, and Psychopathology

“…Nocturnal wakefulness may also increase risk for suicidal thinking. Objectively-measured wakefulness at 4 AM predicted next-day suicidal ideation in individuals with treatment-resistant depression ( Ballard et al, 2016 ), and self-reported wakefulness between 11 PM and 5 AM was associated with greater likelihood of suicidal ideation in both community ( Tubbs et al, 2020a ) and national samples ( Tubbs et al, 2021 ). A similar pattern emerges when examining data from the Internet forum Reddit: posts on a subforum called “SuicideWatch” peaked between 2 AM and 5 AM, whereas posts on a non-suicide related subforum called “AskReddit” peaked between 8 PM and 11 PM ( Dutta et al, 2021 ).…”