Association of Poor Subjective Sleep Quality With Risk for Death by Suicide During a 10-Year Period

Details

• Alternative Title:
  JAMA Psychiatry
• Personal Author:
  Bernert, Rebecca A. ; Turvey, Carolyn L. ; Conwell, Yeates ; Joiner, Thomas E.
• Description:
  IMPORTANCE ; Older adults have high rates of sleep disturbance, die by suicide at disproportionately higher rates compared with other age groups, and tend to visit their physician in the weeks preceding suicide death. To our knowledge, to date, no study has examined disturbed sleep as an independent risk factor for late-life suicide. ; OBJECTIVE ; To examine the relative independent risk for suicide associated with poor subjective sleep quality in a population-based study of older adults during a 10-year observation period. ; DESIGN, SETTING, AND PARTICIPANTS ; A longitudinal case-control cohort study of late-life suicide among a multisite, population-based community sample of older adults participating in the Established Populations for Epidemiologic Studies of the Elderly. Of 14 456 community older adults sampled, 400 control subjects were matched (on age, sex, and study site) to 20 suicide decedents. ; MAIN OUTCOMES AND MEASURES ; Primary measures included the Sleep Quality Index, the Center for Epidemiologic Studies–Depression Scale, and vital statistics. ; RESULTS ; Hierarchical logistic regressions revealed that poor sleep quality at baseline was significantly associated with increased risk for suicide (odds ratio OR, 1.39; 95% CI, 1.14-1.69; P < .001) by 10 follow-up years. In addition, 2 sleep items were individually associated with elevated risk for suicide at 10-year follow-up: difficulty falling asleep (OR, 2.24; 95% CI, 1.27-3.93; P < .01) and nonrestorative sleep (OR, 2.17; 95% CI, 1.28-3.67; P < .01). Controlling for depressive symptoms, baseline self-reported sleep quality was associated with increased risk for death by suicide (OR, 1.30; 95% CI, 1.04-1.63; P < .05). ; CONCLUSIONS AND RELEVANCE ; Our results indicate that poor subjective sleep quality is associated with increased risk for death by suicide 10 years later, even after adjustment for depressive symptoms. Disturbed sleep appears to confer considerable risk, independent of depressed mood, for the most severe suicidal behaviors and may warrant inclusion in suicide risk assessment frameworks to enhance detection of risk and intervention opportunity in late life.
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• Keywords:
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Female
  • Humans
  • Male
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Risk Factors
  • Sleep Wake Disorders
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• Source:
  JAMA Psychiatry. 2014; 71(10):1129-1137
• Pubmed ID:
  25133759
• Pubmed Central ID:
  PMC4283786
• Document Type:
  Journal Article
• Funding:
  R49 CE002093/CE/NCIPC CDC HHSUnited States/ ; F31 MH080470/MH/NIMH NIH HHSUnited States/ ; K23 MH093490/MH/NIMH NIH HHSUnited States/ ; K23MH093490/MH/NIMH NIH HHSUnited States/ ; F31MH080470-01/MH/NIMH NIH HHSUnited States/
• Volume:
  71
• Issue:
  10
• Download URL:
  https://stacks.cdc.gov/view/cdc/30219/cdc_30219_DS1.pdf
• File Type:
  [PDF - 240.63 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:6cf7ba34816341134ce951db5e29cb1cff4d921fdec04ee9a00fbb1fd5007244