Journal article
Association of Poor Subjective Sleep Quality With Risk for Death by Suicide During a 10-Year Period A Longitudinal, Population-Based Study of Late Life
JAMA psychiatry (Chicago, Ill.), Vol.71(10), pp.1129-1137
10/01/2014
DOI: 10.1001/jamapsychiatry.2014.1126
PMCID: PMC4283786
PMID: 25133759
Abstract
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.
Details
- Title: Subtitle
- Association of Poor Subjective Sleep Quality With Risk for Death by Suicide During a 10-Year Period A Longitudinal, Population-Based Study of Late Life
- Creators
- Rebecca A. Bernert - Stanford UniversityCarolyn L. Turvey - University of IowaYeates Conwell - University of Rochester Medical CenterThomas E. Joiner - Florida State University
- Resource Type
- Journal article
- Publication Details
- JAMA psychiatry (Chicago, Ill.), Vol.71(10), pp.1129-1137
- Publisher
- Amer Medical Assoc
- DOI
- 10.1001/jamapsychiatry.2014.1126
- PMID
- 25133759
- PMCID
- PMC4283786
- ISSN
- 2168-622X
- eISSN
- 2168-6238
- Number of pages
- 9
- Grant note
- John Simon Guggenheim Memorial Foundation R49CE002093 / NATIONAL CENTER FOR INJURY PREVENTION AND CONTROL; United States Department of Health & Human Services; Centers for Disease Control & Prevention - USA F31MH080470 / NATIONAL INSTITUTE OF MENTAL HEALTH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Mental Health (NIMH) R49 CE002093 / Centers for Disease Control and Prevention; United States Department of Health & Human Services; Centers for Disease Control & Prevention - USA F31MH080470-01; K23MH093490 / National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA
- Language
- English
- Date published
- 10/01/2014
- Academic Unit
- Psychiatry; Epidemiology
- Record Identifier
- 9984281753902771
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