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Fan X, Ma Y, Zhang J, Lin X, Sun B, Rosenheck R, He H. Sleep disturbance and suicidal ideation among youth with depression. J Affect Disord 2024; 354:232-238. [PMID: 38461901 DOI: 10.1016/j.jad.2024.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/30/2024] [Accepted: 03/07/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Sleep disturbance may exacerbate the risk of suicide among youth with depression, but whether this association is independent of psychopathology requires further study. METHODS This cross-sectional study included 576 youths (13-25 years old) recruited from January 2022 to May 2023. The patients were first divided into two groups by the presence of suicidal ideation according to the Columbia-Suicide Severity Scale (C-SSRS). Sleep quality was assessed by the Athens Insomnia Scale (AIS) and mental health with the Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA). Logistic regression was conducted to analyze the association between sleep disturbance and suicidal ideation, adjusted for depressive symptoms severity. RESULTS The suicidal ideation group exhibited more severe sleep disturbances, anxiety symptoms, and depressive symptoms than the non-suicidal ideation group. Pearson correlation showed that sleep disturbance (AIS) was significantly correlated with the severity of anxiety symptoms, depressive symptoms, and suicidal ideation. Logistic regression analysis revealed that the AIS factor "daytime dysfunction" (β = 0.145; OR = 1.156, 95 % CI: 1.02, 1.309; p = 0.023) was significantly associated with suicidal ideation after adjusting for demographic characteristics and depressive symptoms severity. LIMITATIONS Due to the cross-sectional nature of the data, no causal inference can be made regarding the observed associations between sleep disturbance and suicidal ideation. CONCLUSION Sleep disturbance, particularly in the realm of daytime dysfunction, is associated with increased suicidal ideation among depressed youth. Clinicians need to assess and manage sleep disturbance in the context of suicidal ideation for young depression patients.
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Affiliation(s)
- Xuefei Fan
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; The 3rd People Hospital of Foshan, Foshan, China
| | - Yarong Ma
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jie Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiaoming Lin
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Bin Sun
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Robert Rosenheck
- Department of Psychiatry, Yale Medical School, New Haven, CT, USA
| | - Hongbo He
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.
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Chen Q, Gong L, Song Y, Zhang J, Han X, Zhou Y, Li L, Jiang X, Hao Y, Zhou H, Lou X, Wang X. Associations between multiple sleep dimensions and suicide and non-suicidal self-injury: a cross-sectional study of 3828 Chinese young people. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02689-z. [PMID: 38780778 DOI: 10.1007/s00127-024-02689-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 05/17/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE Suicide and non-suicidal self-injury (NSSI) are preventable concerns in young people. Suicidal ideation (SI), suicidal plans (SP) and suicidal attempt (SA) are closely related to death. Sleep problems are known risk factors for suicide and NSSI. This study aimed to explore the relationship between sleep, suicidality and NSSI. METHODS Participants were 3,828 middle school and college students aged 11-23 years from urban and rural areas of Henan Province. Sleep, suicidal phenomena and NSSI were assessed by applying self-reported questionnaires. Chi-squared tests were utilized to demonstrate the demographic data and sleep variables. The correlation between sleep, suicidality and NSSI were explored by using binary logistic regression, while adjusting socio-demographic characteristics with multivariate models. RESULTS Sleep variables except mid-sleep time were related to suicidal phenomena (P < 0.05). Greater social jet lag (SJL) [≥ 2 h (h)] was associated with increased risk of SI [Odds ratios (OR) = 1.72, 95% confidence intervals (CI):1.40-2.11], SP (OR = 2.10, 95%CI:1.59-2.79) and SA (OR = 1.50, 95%CI:1.00-2.26). Non-only child participants with SJL (≥ 2 h) had significantly increased odds of SI (OR = 1.75, 95%CI: 1.41-2.18) and SP (OR = 2.25, 95%CI: 1.66-3.05). Eveningness chronotype had the strongest correlation with SI (OR = 3.87, 95%CI:2.78-5.38), SP (OR = 4.72, 95%CI:2.97-7.50), SA (OR = 6.69, 95%CI:3.08-14.52) and NSSI (OR = 1.39, 95%CI:1.02-1.90). CONCLUSION Overlong or short sleep duration, SJL, eveningness chronotype and other sleep abnormalities (e.g., daytime dysfunction, low sleep efficiency) were associated with a higher prevalence of SI, SP and SA. Additionally, eveningness was significantly correlated with NSSI among young people. These findings suggested the importance of assessing and intervening in sleep habits to prevent suicide and NSSI in young people.
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Affiliation(s)
- Qiuyuan Chen
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Lu Gong
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Yalin Song
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Jiangtao Zhang
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Xinke Han
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Yuhang Zhou
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Lijie Li
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Xili Jiang
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Yudan Hao
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Huijun Zhou
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Xiaomin Lou
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Xian Wang
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China.
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Liu X, Yang Y, Liu ZZ, Jia CX. Bidirectional associations between sleep problems and suicidal thought/attempt in adolescents: A 3-wave data path analysis. J Affect Disord 2024; 350:983-990. [PMID: 38244795 DOI: 10.1016/j.jad.2024.01.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 01/12/2024] [Accepted: 01/14/2024] [Indexed: 01/22/2024]
Abstract
PURPOSE This longitudinal data analysis examined the bidirectional relationships between sleep problems and suicidal thought (ST)/attempt (SA) in a large sample of Chinese adolescents. METHODS A total of 6995 adolescents (mean age = 14.86 years and 51.4% males) participated in a 3-wave longitudinal study of behavior and health in Shandong, China. A self-administered questionnaire and standardized scales were used to assess ST, SA, sleep duration, insomnia, daytime sleepiness, and behavioral/emotional problems in 2015 (T1), 1 year later (T2), and 2 years later (T3). Path analyses were performed without and with adjustment for covariates, including gender, grade level, chronic diseases, cigarette smoking, alcohol use, anxiety/depressive symptoms, paternal education, and family economic status. RESULTS The prevalence rates of short sleep (<7 h/night), insomnia symptoms, and daytime sleepiness were 46.9-58.8%, 16.0-19.4%, and 25.1-25.3% at T1, T2, and T3, respectively. The rates of past-year ST and SA were 9.1-12.4% and 1.6-2.4% at T1, T2, and T3, respectively. Path analyses showed that short sleep, insomnia, and daytime sleepiness predicted subsequent ST, and vice versa. Daytime sleepiness and SA predicted each other 1 year later. Sleep problems and ST/SA in the previous year significantly predicted themselves in the follow-up year. STUDY LIMITATION All data were based on self-report. CONCLUSION Short sleep, insomnia, and daytime sleepiness all had bidirectional relationships with ST. Daytime sleepiness and SA were bidirectionally linked. Our findings suggest that interventions should be taken for both night sleep disturbances and daytime sleepiness to prevent suicide. Adverse sleep outcomes in suicidal adolescents should be assessed, which can in turn increase suicide risk.
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Affiliation(s)
- Xianchen Liu
- Department of Epidemiology, School of Public Health, Cheeloo Medical College, Shandong University, Jinan 250012, China; South China Normal University School of Psychology, Guangzhou 510631, China; The University of Tennessee Health Science Center, Memphis, TN 38163, USA.
| | - Yanyun Yang
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, FL, USA
| | - Zhen-Zhen Liu
- School of Psychology, Northeast Normal University, Changchun 130024, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo Medical College, Shandong University, Jinan 250012, China
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Fernandes SN, Zuckerman E, Miranda R, Baroni A. When Night Falls Fast: Sleep and Suicidal Behavior Among Adolescents and Young Adults. Psychiatr Clin North Am 2024; 47:273-286. [PMID: 38302212 DOI: 10.1016/j.psc.2023.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Sleep disturbances have been linked to suicidal ideation and behaviors in adolescents. Specifically, insomnia and nightmares are associated with current suicide risk and predict future ideation. Associations between hypersomnia, sleep apnea, and suicide remain inconclusive. Potential biological mechanisms underlying these relationships include executive functioning deficits and hyperarousal. Related psychological factors may include thwarted belongingness, perceived burdensomeness, and negative appraisals. Assessing suicide risk in patients with sleep disturbances, and vice versa, is needed. Therapeutic interventions such as cognitive behavior therapy for insomnia and imagery rehearsal treatment, as well as pharmacologic treatments, show promise in treating sleep disorders and suicidal behavior.
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Affiliation(s)
- Sara N Fernandes
- New York State Psychiatric Institute, Columbia University Irving Medical Center, 1051 Riverside Drive, Room 1600C, New York, NY 10032, USA
| | - Emily Zuckerman
- Department of Child and Adolescent Psychiatry, NYU Langone Health, One Park Avenue, 7th Floor, New York, NY 10016, USA
| | - Regina Miranda
- Department of Psychology, Hunter College and The Graduate Center, City University of New York, 695 Park Avenue, Room 611HN, New York, NY 10065, USA
| | - Argelinda Baroni
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, One Park Avenue, 7th Floor, New York, NY 10016, USA.
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Yu Y, Feng Y, Xu S, Wilson A, Chen C, Ling X, Chen R, Wang Y. The influence of childhood trauma and chronotype on suicide attempts in Chinese emerging adults with severe depressive symptoms. BMC Psychol 2024; 12:12. [PMID: 38173011 PMCID: PMC10765889 DOI: 10.1186/s40359-023-01472-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 11/29/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Studies have investigated how adults with severe depressive symptoms are more likely to attempt suicide, and these adults often have traumatic experiences and chaotic sleep/wake rhythms. Thus, this study using Latent class analysis aimed to investigate the relationship between childhood trauma class, chronotype, and suicide attempts among emerging adults with severe depressive symptoms. METHODS This study was conducted among emerging adults with severe depressive symptoms covering 63 Universities in Jilin Province, China. A total of 1,225 emerging adults (mean age = 19.6 ± 1.78) constructed the final sample. In addition to measuring socio-demographic characteristics, the Childhood Trauma Questionnaire-Short Form, the Single-Item Chronotyping, and a single item for suicide attempts were used to evaluate childhood trauma, chronotype, and suicide attempts, respectively. Latent class analysis was applied to identify the classes of childhood trauma within emerging adults who had severe depressive symptoms. Hierarchical logistic regression models were run to investigate the effects of socio-demographic characteristics, chronotype, and childhood trauma class on suicide attempts. RESULTS Three latent classes were identified: the Low-risk for childhood trauma class, the Neglect class, and the High-risk for childhood abuse class. Those who suffered sexual, emotional, and physical abuse at the same time were divided into the High-risk for childhood abuse class, and were significantly more likely to experience suicide attempts than those in the Neglect class (OR = 1.97, 95%CI = 1.34-2.89, p < 0.001) and the Low-risk for childhood trauma class (OR = 2.28, 95% CI = 1.50-3.46, p < 0.001). In terms of chronotype, the results showed that the chaotic type was a risk factor for suicide attempts when compared with the evening type (OR = 0.46, 95%CI = 0.27-0.78, p < 0.01), the moderately active type (OR = 0.53, 95%CI = 0.31-0.89, p < 0.05), and the daytime type (OR = 0.42, 95%CI = 0.21-0.86, p < 0.05). Overall, the significant risk factors for suicide attempts included being female, living in an urban area, having experienced sexual, emotional, and physical abuse simultaneously, and having a chaotic chronotype. CONCLUSION Emerging adults suffering sexual, emotional, and physical abuse at the same time and identifying with chaotic chronotype showed a higher risk of attempting suicide. The findings provided a clinical reference to quickly identify those at high risk of suicide attempts among emerging adults with severe depressive symptoms.
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Affiliation(s)
- Yi Yu
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Yi Feng
- Mental Health Center, Central University of Finance and Economics, Beijing, China
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Shicun Xu
- Northeast Asian Research Center, Jilin University, Changchun, China
- Department of Population, Resources and Environment, Northeast Asian Studies College, Jilin University, Changchun, China
- China Center for Aging Studies and Social-Economic Development, Jilin University, Changchun, China
| | - Amanda Wilson
- Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Chang Chen
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Xi Ling
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Runsen Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yuanyuan Wang
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.
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Hu L, Wang Z, Yang Y, Liu X. Psychometric properties of the Youth Self-rated Insomnia Scale (YSIS) in adolescent psychiatric patients. Sleep Biol Rhythms 2024; 22:103-111. [PMID: 38476857 PMCID: PMC10900025 DOI: 10.1007/s41105-023-00487-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 08/29/2023] [Indexed: 03/14/2024]
Abstract
The 8-item Youth Self-rated Insomnia Scale (YSIS) was developed to assess insomnia severity in the past month among youths. The YSIS has satisfactory psychometric properties in the general adolescent population. This study examined psychometric properties of the YSIS in a large sample of adolescent psychiatric patients. A total of 536 patients aged 10-19 years were consecutively recruited from the outpatient department of Shandong Mental Health Center between December 2021 and March 2022. Patients completed a structured questionnaire consisting of the YSIS scale and questions about sleep duration, nightmares, psychiatric history, depression, psychiatric and sleep medications, and demographics. Patients were diagnosed following the ICD-10 criteria. Of the participants, the mean age was 15.30 years (SD = 1.95), 61.0% were female, 60.9% were diagnosed with mood disorders, 65.7% were on antidepressants, and 49.0% were on anxiolytics or hypnotics. The mean YSIS score was 22.6 (SD = 8.07). Coefficient omega was 0.84. Exploratory factor analysis revealed one factor and two correlated residuals. The YSIS scores were significantly correlated with depression scores (r = 0.68) and significantly increased with sleep onset latency, short sleep duration, nightmare frequency, and sleep medication use. The YSIS demonstrated satisfactory internal consistency reliability, construct validity, and criteria-related validity in adolescent psychiatric patients. The YSIS appears to be a reliable and valid scale for measuring insomnia severity in adolescent psychiatric patients.
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Affiliation(s)
- Lei Hu
- Shandong Mental Health Center, Shandong University, 49 Wen Hua Dong Road, Jinan, 250014 China
| | - Ziyang Wang
- School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yanyun Yang
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, FL 32306 USA
| | - Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA 19104 USA
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Zeghari R, Gindt M, Guivarch J, Auby P, Robert P, Rolling J, Schröder C, Valo P, Askenazy F, Fernandez A. July 14th 2016 Nice Terrorist Attack Court Trial: A Protocol on Sleep Quality and Somatic Symptoms as Markers of Risk for Traumatic Reactivation in Adolescents Exposed to This Attack. Healthcare (Basel) 2023; 11:2953. [PMID: 37998445 PMCID: PMC10671086 DOI: 10.3390/healthcare11222953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 11/05/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023] Open
Abstract
The court trial of the 14th of July 2016 terrorist attack in Nice (France) opened in September 2022 and ended in December 2022. Engaging in court proceedings, whether as a victim or a witness, can lead to a significant risk of traumatic reactivation (i.e., the re-emergence of post-traumatic stress symptoms). The present protocol aimed to improve knowledge of the pathophysiology of traumatic reactivation due to the media coverage of the trial by assessing sleep disturbances and somatic symptoms that could reappear if there is a traumatic reactivation. Method and Analysis: This is a monocentric longitudinal study, with recruitment solely planned at the Nice Pediatric Psychotrauma Center (NPPC). We intended to include 100 adolescents aged 12 to 17 years who were directly or indirectly exposed to the attack and included in the "14-7" program). Assessments began one month before the trial, in August 2022, and were scheduled once a month until the end of the trial. A smartwatch recorded sleep activity. Somatic and PTSD symptoms and sleep were assessed through validated questionnaires. The main analyses comprised the variance and regression analyses of predictors of clinical evolution over time. Ethics and Dissemination: The National Ethics Committee "NORD OUEST III" approved the "14-7" program protocol (number 2017-A02212-51). The specific amendment for this research was approved in April 2022 by the same national ethical committee. Inclusions started in August 2022.
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Affiliation(s)
- Radia Zeghari
- Nice Pediatric Psychotrauma Center (NPPC), Child and Adolescent Psychiatry Department, Hôpitaux Pédiatriques Universitaires Lenval, 06200 Nice, France
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, 06000 Nice, France
| | - Morgane Gindt
- Nice Pediatric Psychotrauma Center (NPPC), Child and Adolescent Psychiatry Department, Hôpitaux Pédiatriques Universitaires Lenval, 06200 Nice, France
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, 06000 Nice, France
| | - Jokthan Guivarch
- Department of Child Psychiatry, APHM, 13009 Marseille, France;
- CANOP Institut de Neurosciences de la Timone, UMR 7289, CNRS, Aix Marseille University, 13005 Marseille, France
- Faculty of Medicine, Aix-Marseille University, 13005 Marseille, France
| | - Philippe Auby
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, 06000 Nice, France
| | - Philippe Robert
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, 06000 Nice, France
| | - Julie Rolling
- Regional Center for Psychotraumatism Great East, Strasbourg University Hospital, 67000 Strasbourg, France
- Department of Child and Adolescent Psychiatry, Strasbourg University Hospitals, 67000 Strasbourg, France
- CNRS UPR3212-Research Team “Light, Circadian Rhythms, Sleep Homeostasis and Neuropsychiatry”, Institute of Cellular and Integrative Neurosciences, 67000 Strasbourg, France
- Excellence Centre for Autism and Neurodevelopmental Disorders STRAS&ND, 67091 Strasbourg, France
- Sleep Disorders Centre & International Research Centre for ChronoSomnology (Circsom), University Hospitals Strasbourg, 67091 Strasbourg, France
| | - Carmen Schröder
- Department of Child and Adolescent Psychiatry, Strasbourg University Hospitals, 67000 Strasbourg, France
- CNRS UPR3212-Research Team “Light, Circadian Rhythms, Sleep Homeostasis and Neuropsychiatry”, Institute of Cellular and Integrative Neurosciences, 67000 Strasbourg, France
- Excellence Centre for Autism and Neurodevelopmental Disorders STRAS&ND, 67091 Strasbourg, France
- Sleep Disorders Centre & International Research Centre for ChronoSomnology (Circsom), University Hospitals Strasbourg, 67091 Strasbourg, France
- Expert Centre for High-Functioning Autism, Fondation FondaMental, 67000 Strasbourg, France
| | - Petri Valo
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, 06000 Nice, France
| | - Florence Askenazy
- Nice Pediatric Psychotrauma Center (NPPC), Child and Adolescent Psychiatry Department, Hôpitaux Pédiatriques Universitaires Lenval, 06200 Nice, France
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, 06000 Nice, France
| | - Arnaud Fernandez
- Nice Pediatric Psychotrauma Center (NPPC), Child and Adolescent Psychiatry Department, Hôpitaux Pédiatriques Universitaires Lenval, 06200 Nice, France
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, 06000 Nice, France
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Vacca M, Spanetta M, Ballesio A, Fernandes M, Placidi F, Izzi F, Lombardo C, Mercuri NB, Laganà G, Liguori C. The Sleepiness-Depression Link in Obstructive Sleep Apnea: Preliminary Results on the Mediation of Impulsivity. J Clin Med 2023; 12:6467. [PMID: 37892605 PMCID: PMC10607807 DOI: 10.3390/jcm12206467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/23/2023] [Accepted: 10/07/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Emotional impulsivity has been found to be relevant in explaining the association between sleep problems and depressive symptoms, suggesting the potential role of impulsivity as a key underlying mechanism of this link. The objective of this study was to take a preliminary step in understanding the mediating role of impulsivity in the relation between excessive daytime sleepiness (EDS) and depression in patients with obstructive sleep apnea syndrome (OSAS) and to compare psychological and demographic characteristics between different levels of daytime sleepiness. METHODS A total of 138 patients with OSAS underwent polygraphic cardiorespiratory monitoring and completed a series of questionnaires investigating perceived sleepiness, depression, impulsivity, and other psychological characteristics. A mediational model was tested in order to assess whether impulsivity mediated the relation between sleepiness and depressive symptoms while controlling for the effects of age, sex, BMI, and oxygen saturation parameters. RESULTS the mediation model showed that there was a significant indirect effect of impulsivity in the sleepiness-depression link (αβ = 0.084 [0.0243-0.1617]). CONCLUSIONS The here-presented results showed that the sleepiness-depression link is not direct as previous studies asserted, but instead it may be better explained by impulsivity. Research and practical implications are discussed.
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Affiliation(s)
- Mariacarolina Vacca
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (M.V.); (A.B.); (C.L.)
| | | | - Andrea Ballesio
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (M.V.); (A.B.); (C.L.)
| | - Mariana Fernandes
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (M.F.); (F.P.); (N.B.M.)
| | - Fabio Placidi
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (M.F.); (F.P.); (N.B.M.)
- Sleep Medicine Center, Neurology Unit, University Hospital of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Francesca Izzi
- Sleep Medicine Center, Neurology Unit, University Hospital of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Caterina Lombardo
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (M.V.); (A.B.); (C.L.)
| | - Nicola Biagio Mercuri
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (M.F.); (F.P.); (N.B.M.)
- Sleep Medicine Center, Neurology Unit, University Hospital of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Giuseppina Laganà
- Department of Orthodontics, University of Rome “Tor Vergata”, 00133 Rome, Italy;
| | - Claudio Liguori
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (M.F.); (F.P.); (N.B.M.)
- Sleep Medicine Center, Neurology Unit, University Hospital of Rome “Tor Vergata”, 00133 Rome, Italy
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9
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Chen S, Li H, Wen D. Social Support and Daytime Sleepiness Among Chinese Medical Students: Mediating Roles of Loneliness and Problematic Smartphone Use. Psychol Res Behav Manag 2023; 16:4083-4093. [PMID: 37817912 PMCID: PMC10561758 DOI: 10.2147/prbm.s432400] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/25/2023] [Indexed: 10/12/2023] Open
Abstract
Background Sleep problems have become a serious threat to public health worldwide. Daytime sleepiness is an important indicator of many sleep problems, which have a significant impact on academic performance, physical and mental health, and wellbeing among medical students. We aimed to explore the factors associated with daytime sleepiness among medical students. Methods We conducted a cross-sectional survey of 466 medical students recruited via convenience sampling. Self-rated psychometric scales, including the Social Support Rate Scale, the Epworth Sleepiness Scale, the Chinese version of the UCLA loneliness scale, and the Mobile Phone Addiction Index (MPAI), were utilized to evaluate social support, daytime sleepiness, loneliness, and problematic smartphone use. A sequential mediation model was constructed with daytime sleepiness as the dependent variable, social support as the independent variable, and loneliness and problematic smartphone use as mediating variables. Age, gender, and grade were taken as covariates. Results Social support among medical students was negatively associated with loneliness, problematic smartphone use, and daytime sleepiness (p < 0.01). A sequential mediation analysis showed that loneliness (the first mediator) and problematic smartphone use (the second mediator) sequentially mediated the path from social support to daytime sleepiness among medical students (β = -0.008; 95% CI = -0.016, -0.002). Moreover, there were also significant mediating roles observed in the relationship between social support and daytime sleepiness via loneliness only (β = -0.037; 95% CI = -0.062, -0.015) and problematic smartphone use only (β = -0.022; 95% CI = -0.041, -0.008). Conclusion Social support, loneliness, and problematic smartphone use among medical students influenced their daytime sleepiness. Interventions targeting medical student loneliness and problematic smartphone use behaviors might attenuate the effects from low levels of social support and further improve daytime sleepiness.
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Affiliation(s)
- Sijian Chen
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, People’s Republic of China
- School of Nursing, China Medical University, Shenyang, People’s Republic of China
| | - Honghe Li
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, People’s Republic of China
| | - Deliang Wen
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, People’s Republic of China
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10
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Maruani J, Molière F, Godin O, Yrondi A, Bennabi D, Richieri R, El-Hage W, Allauze E, Anguill L, Bouvard A, Camus V, Dorey JM, Etain B, Fond G, Genty JB, Haffen E, Holtzmann J, Horn M, Kazour F, Nguon AS, Petrucci J, Rey R, Stephan F, Vaiva G, Walter M, Lejoyeux M, Leboyer M, Llorca PM, Courtet P, Aouizerate B, Geoffroy PA. Diurnal symptoms of sleepiness and dysfunction predict future suicidal ideation in a French cohort of outpatients (FACE-DR) with treatment resistant depression: A 1-year prospective study about sleep markers. J Affect Disord 2023; 329:369-378. [PMID: 36842655 DOI: 10.1016/j.jad.2023.02.106] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 02/19/2023] [Accepted: 02/20/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND Patients suffering from treatment-resistant depression (TRD) are at risk of suicide. Sleep and circadian rhythm alterations are widely recognized as core symptoms of major depressive disorder and are associated with suicidal ideation. Thus, sleep and circadian rhythm alterations may be targeted to prevent suicide. METHODS Patients were recruited from a prospective cohort of the French network of TRD expert centers. Mood, sleep and circadian rhythms were assessed at baseline; suicidal risk was assessed both at baseline and during a one-year follow-up with standardized subjective questionnaires. RESULTS Excessive daytime sleepiness (adjusted odds ratio aOR = 1.7(1-3.3), p = 0.04) and daytime dysfunction (aOR = 1.81(1.16-2.81), p = 0.0085) increased the risk of suicidal thoughts over the one-year follow-up period in patients with TRD after adjustment on age, gender, depression, trauma, anxiety, impulsivity, current daily tobacco smoking and body mass index. Hypnotics intake is associated with a reduced risk of suicidal ideation at one-year follow-up after the same adjustments (OR = 0.73(0.56-0.95), p = 0.019). Other associations between sleep quality or circadian rhythms and suicidal ideations at either baseline or one year did not remain significant in multivariate analyses after the same adjustments. LIMITATIONS Sleep assessments were based on self-reported questionnaires rather than objective measures. CONCLUSIONS Daytime sleepiness and dysfunction are predictors of suicidal ideations, whereas hypnotics intake is associated with a reduced risk of suicidal ideations. Diurnal symptoms of sleep disturbances are therefore red flags to target for preventing suicide in depressed patients, and hypnotics seem efficient in preventing suicide for patients with TRD.
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Affiliation(s)
- Julia Maruani
- Fondation FondaMental, Creteil, France; Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, F-75018 Paris, France; Université de Paris, NeuroDiderot, Inserm, FHU I2-D2, F-75019 Paris, France.
| | - Fanny Molière
- Fondation FondaMental, Creteil, France; Department of Emergency Psychiatry and Acute Care, CHU Montpellier, INSERM U1061, Montpellier University, Montpellier, France
| | - Ophelia Godin
- Fondation FondaMental, Creteil, France; INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, 94000 Créteil, France
| | - Antoine Yrondi
- Fondation FondaMental, Creteil, France; Service de Psychiatrie et de Psychologie Médicale de l'adulte (Department of Psychiatry and Adult Medical Psychology), Centre Expert Dépression Résistante FondaMental (FondaMental Advanced Centre of Expertise in Resistant Depression, CHU de Toulouse (University Hospital Centre), Hôpital Purpan, ToNIC Toulouse NeuroImaging Centre, Université de Toulouse (Toulouse University), INSERM, UPS, Toulouse, France
| | - Djamila Bennabi
- Fondation FondaMental, Creteil, France; Service de Psychiatrie, Centre Expert Dépression Résistante FondaMental, CIC-1431 INSERM, CHU de Besançon, Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive UR-LINC 481, Neurosciences, Université de Bourgogne Franche Comté, Besançon, France
| | - Raphaelle Richieri
- Fondation FondaMental, Creteil, France; Aix Marseille Univ, CNRS, Centrale Marseille, Institut Fresnel, Marseille, France
| | - Wissan El-Hage
- Fondation FondaMental, Creteil, France; CHRU de Tours, UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Etienne Allauze
- Fondation FondaMental, Creteil, France; Université Clermont Auvergne, CMP-B CHU, CNRS, Clermont Auvergne INP, Institut Pascal, F-63000 Clermont-Ferrand, France
| | - Loic Anguill
- Fondation FondaMental, Creteil, France; Service de Psychiatrie et de Psychologie Médicale de l'adulte (Department of Psychiatry and Adult Medical Psychology), Centre Expert Dépression Résistante FondaMental (FondaMental Advanced Centre of Expertise in Resistant Depression, CHU de Toulouse (University Hospital Centre), Hôpital Purpan, ToNIC Toulouse NeuroImaging Centre, Université de Toulouse (Toulouse University), INSERM, UPS, Toulouse, France
| | - Alexandra Bouvard
- Fondation FondaMental, Creteil, France; Pôle de Psychiatrie Générale et Universitaire (Department of General and University Academic Psychiatry Cluster), Centre de référence régional des pathologies anxieuses et de la dépression (Regional reference center for the management and treatment of anxiety and depressive disorders), Centre Expert Dépression Résistante FondaMental (FondaMental Advan-ced Centre of Expertise in Resistant Depression), CH Charles Perrens, Bordeaux, Laboratoire Nutrition et Neurobiologie intégrée (Integrated Nutrition and Neurobiology Laboratory) (UMR INRAE 1286), Université de Bordeaux (Bordeaux University), France
| | - Vincent Camus
- Fondation FondaMental, Creteil, France; CHRU de Tours, UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Jean-Michel Dorey
- Fondation FondaMental, Creteil, France; INSERM U1028; CNRS UMR5292; University Lyon 1; Lyon Neuroscience Research Centre; Psychiatric Disorders: from Resistance to Response ΨR2 Team; Centre Hospitalier Le Vinatier (Hospital Centre); F-69678, France
| | - Bruno Etain
- Fondation FondaMental, Creteil, France; Université Paris Cité et AP-HP.Nord, GHU Lariboisière-Fernand Widal, Département de Psychiatrie et de Médecine Addictologique et Fondation Fondamental, Paris, France
| | - Guillaume Fond
- Fondation FondaMental, Creteil, France; Aix-Marseille Univ, School of medicine - La Timone Medical Campus, EA 3279: Department of Epidemiology and Health Economics, Clinical Research Unit, Direction de la Recherche en Santé, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - Jean-Baptiste Genty
- Fondation FondaMental, Creteil, France; AP-HP, Hôpital Henri Mondor, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision (FHU ADAPT); Université Paris Est Créteil, INSERM U955, IMRB, Laboratoire Neuro-Psychiatrie translationnelle, Fondation FondaMental, F-94010 Créteil, France
| | - Emmanuel Haffen
- Fondation FondaMental, Creteil, France; Service de Psychiatrie, Centre Expert Dépression Résistante FondaMental, CIC-1431 INSERM, CHU de Besançon, Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive UR-LINC 481, Neurosciences, Université de Bourgogne Franche Comté, Besançon, France
| | - Jérôme Holtzmann
- Fondation FondaMental, Creteil, France; Service Hospitalo-Universitaire de Psychiatrie, CHU Grenoble Alpes, Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences (Institute of Neurosciences), 38000 Grenoble, France
| | - Mathilde Horn
- Fondation FondaMental, Creteil, France; Service de Psychiatrie adulte (Department of Adult Psychiatry), Centre Expert Dépression Résistante FondaMental, CHRU de Lille, Hôpital Fontan 1, Lille, France
| | - François Kazour
- Fondation FondaMental, Creteil, France; CHRU de Tours, UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Anne-Sophie Nguon
- Fondation FondaMental, Creteil, France; Service Hospitalo-Universitaire de Psychiatrie, CHU Grenoble Alpes, Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences (Institute of Neurosciences), 38000 Grenoble, France
| | - Jean Petrucci
- Fondation FondaMental, Creteil, France; AP-HP, Hôpital Henri Mondor, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision (FHU ADAPT); Université Paris Est Créteil, INSERM U955, IMRB, Laboratoire Neuro-Psychiatrie translationnelle, Fondation FondaMental, F-94010 Créteil, France
| | - Romain Rey
- Fondation FondaMental, Creteil, France; INSERM U1028; CNRS UMR5292; University Lyon 1; Lyon Neuroscience Research Centre; Psychiatric Disorders: from Resistance to Response ΨR2 Team; Centre Hospitalier Le Vinatier (Hospital Centre); F-69678, France
| | - Florian Stephan
- Fondation FondaMental, Creteil, France; Service Hospitalo-Universitaire de Psychiatrie Générale et de Réhabilitation Psycho Sociale 29G01 et 29G02 (University Hospital Department of General Psychiatry and Psychosocial Rehabilitation), Centre Expert Depression Résistante FondaMental, EA 7479, URCI, CHRU de Brest, Hôpital de Bohars, Brest, France
| | - Guillaume Vaiva
- Fondation FondaMental, Creteil, France; Service de Psychiatrie adulte (Department of Adult Psychiatry), Centre Expert Dépression Résistante FondaMental, CHRU de Lille, Hôpital Fontan 1, Lille, France; Centre National de Ressources et Résilience pour les psychotraumatismes (Cn2r Lille Paris), Lille, France
| | - Michel Walter
- Fondation FondaMental, Creteil, France; Service Hospitalo-Universitaire de Psychiatrie Générale et de Réhabilitation Psycho Sociale 29G01 et 29G02 (University Hospital Department of General Psychiatry and Psychosocial Rehabilitation), Centre Expert Depression Résistante FondaMental, EA 7479, URCI, CHRU de Brest, Hôpital de Bohars, Brest, France
| | | | - Michel Lejoyeux
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, F-75018 Paris, France; Université de Paris, NeuroDiderot, Inserm, FHU I2-D2, F-75019 Paris, France; GHU Paris, Psychiatry & Neurosciences, 1 rue Cabanis, 75014 Paris, France
| | - Marion Leboyer
- Fondation FondaMental, Creteil, France; AP-HP, Hôpital Henri Mondor, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision (FHU ADAPT); Université Paris Est Créteil, INSERM U955, IMRB, Laboratoire Neuro-Psychiatrie translationnelle, Fondation FondaMental, F-94010 Créteil, France
| | - Pierre-Michel Llorca
- Fondation FondaMental, Creteil, France; Université Clermont Auvergne, CMP-B CHU, CNRS, Clermont Auvergne INP, Institut Pascal, F-63000 Clermont-Ferrand, France
| | - Philippe Courtet
- Fondation FondaMental, Creteil, France; Department of Emergency Psychiatry and Acute Care, CHU Montpellier, INSERM U1061, Montpellier University, Montpellier, France
| | - Bruno Aouizerate
- Fondation FondaMental, Creteil, France; Pôle de Psychiatrie Générale et Universitaire (Department of General and University Academic Psychiatry Cluster), Centre de référence régional des pathologies anxieuses et de la dépression (Regional reference center for the management and treatment of anxiety and depressive disorders), Centre Expert Dépression Résistante FondaMental (FondaMental Advan-ced Centre of Expertise in Resistant Depression), CH Charles Perrens, Bordeaux, Laboratoire Nutrition et Neurobiologie intégrée (Integrated Nutrition and Neurobiology Laboratory) (UMR INRAE 1286), Université de Bordeaux (Bordeaux University), France
| | - Pierre A Geoffroy
- Fondation FondaMental, Creteil, France; Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, F-75018 Paris, France; Université de Paris, NeuroDiderot, Inserm, FHU I2-D2, F-75019 Paris, France; CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, 5 rue Blaise Pascal, 67000 Strasbourg, France; GHU Paris, Psychiatry & Neurosciences, 1 rue Cabanis, 75014 Paris, France.
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11
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Dong QY, Yang XF, Liu BP, Zhang YY, Wan LP, Jia CX. Menstrual pain mediated the association between daytime sleepiness and suicidal risk: A prospective study. J Affect Disord 2023; 328:238-244. [PMID: 36806594 DOI: 10.1016/j.jad.2023.02.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/05/2023] [Accepted: 02/11/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND Adolescents with daytime sleepiness have been demonstrated to have a higher level of suicidal risk than those without. Currently, few studies had examined the pathway from daytime sleepiness to suicidal risk among female adolescents. This study aimed to explore the association among menstrual pain, daytime sleepiness, and suicidal risk among female adolescents in China. METHODS Of 7072 adolescents who participated in the follow-up survey of Shandong Adolescents Behavior & Health Cohort (SABHC), 3001 were female adolescents who had begun to menstruate and included for the analysis. A structured self-administrated questionnaire was used to measure menstrual pain, daytime sleepiness, suicidal risk and demographic characteristics. Participants were first surveyed in November-December 2015 and resurveyed 1 year later. RESULTS Of 3001 participants, 11.43 % had suicidal risk, 79.8 % experienced menstrual pain. Cross-lagged analysis showed that there was cause-and-effect relationship between menstrual pain and daytime sleepiness. Moderate (OR = 1.79, 95%CI: 1.22-2.63) and severe (OR = 2.73, 95%CI: 1.80-4.12) menstrual pain (follow-up) were associated with suicidal risk (follow-up). Daytime sleepiness (baseline: OR = 1.04, 95%CI: 1.02-1.06, follow-up: OR = 1.07, 95%CI: 1.05-1.09) had effects on suicidal risk (follow-up). Mediation analysis showed that menstrual pain played a partially mediating role between daytime sleepiness and suicidal risk, with the indirect effect being 0.002 (95%CI: 0.001-0.004). LIMITATIONS All data were self-reported. CONCLUSIONS Menstrual pain and daytime sleepiness had effects on each other, and they both were the risk factors of suicidal risk. Among female adolescents, the association between daytime sleepiness and suicidal risk could be partially mediated by menstrual pain. Releasing the menstrual pain of female adolescents with daytime sleepiness could reduce their suicidal risk.
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Affiliation(s)
- Qiu-Yue Dong
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China; Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China
| | - Xiao-Fan Yang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China; Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China
| | - Bao-Peng Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China; Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China
| | - Ying-Ying Zhang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China; Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China
| | - Li-Peng Wan
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China; Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China; Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China.
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12
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Chu CS, Huang KL, Bai YM, Su TP, Tsai SJ, Chen TJ, Hsu JW, Liang CS, Chen MH. Risk of suicide after a diagnosis of sleep apnea: A nationwide longitudinal study. J Psychiatr Res 2023; 161:419-425. [PMID: 37028128 DOI: 10.1016/j.jpsychires.2023.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 02/15/2023] [Accepted: 03/19/2023] [Indexed: 04/09/2023]
Abstract
Previous studies have presented evidence on the association between sleep apnea and suicidal ideation and planning, but the relationship between a clinical diagnosis of sleep apnea and suicide attempts remains unknown. We investigated the risk of suicide after a diagnosis with sleep apnea using data from a nationwide community-based population database, i.e., the Taiwan National Health Insurance Research Database. We recruited 7,095 adults with sleep apnea and 28,380 age-, sex-, and comorbidity-matched controls between 1998 and 2010 and followed them up until the end of 2011. Individuals who exhibited any (once or repeated) suicide attempts were identified during the follow-up period. The E value was calculated for unmeasured bias. Sensitivity analysis was conducted. Patients with sleep apnea were more likely to carry out any suicide attempt (hazard ratio: 4.53; 95% confidence interval: 3.48-5.88) during the follow-up period than the controls after adjusting for demographic data, mental disorders, and physical comorbidities. The hazard ratio remained significant after excluding individuals with mental disorders (4.23; 3.03-5.92). The hazard ratio was 4.82 (3.55-6.56) for male patients and 3.86 (2.33-6.38) for female patients. Consistent findings of increased risk of repeated suicide attempt were found among patients with sleep apnea. No association was found between continuous positive airway pressure treatment and suicide risk. The calculated E values support suicide risk after the diagnosis of sleep apnea. The risk of suicide was 4.53-fold higher in patients diagnosed with sleep apnea than in their counterparts without sleep apnea.
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Affiliation(s)
- Che-Sheng Chu
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan; Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan; Non-invasive Neuromodulation Consortium for Mental Disorders, Society of Psychophysiology, Taipei, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kai-Lin Huang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Psychiatry, Cheng Hsin General Hospital, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chih-Sung Liang
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan.
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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13
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Davidson-Urbain W, Servot S, Godbout R, Montplaisir JY, Touchette E. [Sleepiness among adolescents: etiology and multiple consequences]. L'ENCEPHALE 2023; 49:87-93. [PMID: 35970642 DOI: 10.1016/j.encep.2022.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 01/21/2023]
Abstract
Over the past century a dramatic decline in sleep duration among adolescents, such as more than one hour of sleep loss per night, has been reported. A debt in sleep duration could lead to sleep deprivation, a major risk factor associated with daytime sleepiness. Sleepiness refers to the inability to maintain an adequate level of alertness during the day which may result in more or less being able to control falling asleep at inappropriate times. This literature review updates on sleepiness regarding its characteristics, etiology and consequences on adolescents. Studies revealed that from 25 % to 78 % of adolescents had reported sleepiness. Its manifestations may include heavy lids, yawns, difficulties to concentrate and emotional irritability. In addition, while it is recommended that adolescents under 18 years-old should sleep from eight to ten hours a night, only 63 % of them actually do so. The etiology of sleep deprivation and sleepiness in this population can be explained by various biological and societal factors. First, the sleep-wake cycle of adolescents shows a biological shift from the beginning of pubertal maturation, described as a perfect storm. It refers to a social jetlag by going to sleep and waking up later and accumulating a sleep debt during weekdays which they try to reimburse during weekends. This phenomenon can be explained by physiological changes such as a slower accumulation of sleep pressure. In addition to this perfect storm, environmental and societal factors contribute to the social jetlag and reduce sleep duration in adolescents. Screen exposure before bedtime can delay sleep and wake onset, which is a risk factor for sleeping debt. Substance use such as caffeine, cigarettes or electronic vaporizer, ADHD or freely available medication, alcohol, cannabis use or drug consumption could further disrupt sleep-wake cycle by stimulating, depressing or otherwise disrupting the central nervous system. Early, before 8:30 am, class start times have been associated with chronic sleep deprivation, higher level of sleepiness and delayed melatonin peak secretion. Adolescents working or doing extracurricular occupations for more than 20hours a week are more at risk for reduced sleep duration and sleepiness. Parental supervision about sleep during the weekdays were associated with more appropriate bedtime. Adolescents from low socio-demographic characteristics and from minority ethnic groups have reported displaying a shorter sleep duration. Finally, sleep disorders of a physiological origin such as narcolepsy, sleep apnea or restless legs syndrome, may explain the sleep deprivation and sleepiness. Sleep deprivation and sleepiness in adolescents have consequences on their health. Cognitive functioning, such as problem solving, attention or memory, as well as school performance, can be compromised by sleep deprivation and sleepiness. At the psychological level, adolescents reporting sleepiness are more prone to display mental health problems: associations were found between sleepiness and subjective perception of depression, anxiety, somatic complaints as well as with antisocial behaviors. Finally, 68 % of 16 year-old adolescents reported they drove a car, and the reported sleepiness could lead to road accidents due to reduced attentional functioning, reaction time and decision-making abilities. In the United-States, from 7 % to 16.5 % of deadly accidents were related to driving while drowsy. Highlighting etiology and problems associated with sleep deprivation and sleepiness in adolescents could guide researchers and clinicians towards the development of possible interventions. Public health measures and knowledge transfer programs regarding modifiable psychosocial and societal factors associated with sleep-wake bioregulation could increase awareness in parents as well as in political and societal decision makers.
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Affiliation(s)
- W Davidson-Urbain
- Département de psychiatrie et addictologie, université de Montréal, Montréal, Canada
| | - S Servot
- Département de psychoéducation, université du Québec à Trois-Rivières, Québec, Canada; Centre de recherche universitaire sur les jeunes et les familles, Québec, Canada
| | - R Godbout
- Département de psychiatrie et addictologie, université de Montréal, Montréal, Canada; Laboratoire et Clinique du sommeil, hôpital en santé mentale Rivière-des-Prairies, CIUSSS du Nord-de-l'Île-de-Montréal, Montréal, Canada
| | - J-Y Montplaisir
- Département de psychiatrie et addictologie, université de Montréal, Montréal, Canada; Centre d'études avancées en médecine du sommeil, hôpital du Sacré-Cœur, Québec, Canada
| | - E Touchette
- Département de psychoéducation, université du Québec à Trois-Rivières, Québec, Canada; Centre de recherche universitaire sur les jeunes et les familles, Québec, Canada; Centre d'études avancées en médecine du sommeil, hôpital du Sacré-Cœur, Québec, Canada; Centre intégré universitaire de santé et de services sociaux du Nord-de-l'île-de-Montréal, Québec, Canada; Groupe de recherche en inadaptation psychosociale, Québec, Canada.
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14
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Liu X, Yang Y, Liu Z, Jia C. Associations between Insomnia, Daytime Sleepiness, and Depressive Symptoms in Adolescents: A Three-Wave Longitudinal Study. J Clin Med 2022; 11:jcm11236912. [PMID: 36498487 PMCID: PMC9739758 DOI: 10.3390/jcm11236912] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/13/2022] [Accepted: 11/18/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Insomnia, daytime sleepiness, and depressive symptoms are prevalent in adolescents. This three-wave prospective study examined the associations between the three symptoms in adolescents. METHODS A total of 6995 schoolchildren in 7th and 10th grades (Mean age = 14.86 years) participated in a longitudinal study of behavior and health in Shandong, China. Standardized rating scales were used to assess symptoms of insomnia, daytime sleepiness, and depression in November-December in 2015, 1 year later, and 2 years later. RESULTS Insomnia was cross-sectionally associated with 10-14-fold increased odds of daytime sleepiness and 5-9-fold increased odds of depression. Daytime sleepiness was associated with 4-5-fold increased odds of depression. Insomnia, daytime sleepiness, or depression at a later time point was significantly predicted by itself at earlier time points. Insomnia was a significant predictor of daytime sleepiness and depression and a mediator between depression and daytime sleepiness. Daytime sleepiness was a significant predictor of insomnia and a mediator between depression and insomnia. Depression was a significant predictor of insomnia and daytime sleepiness and a mediator between insomnia and daytime sleepiness. CONCLUSIONS Insomnia, daytime sleepiness, and depressive symptoms were highly comorbid in adolescents. The associations of insomnia with daytime sleepiness and depression were bidirectional. Depression predicted daytime sleepiness, but not vice versa. Further research is needed to understand the underlying neurobiological mechanisms between insomnia, daytime sleepiness, and depression during adolescence.
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Affiliation(s)
- Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA 19104, USA
- Correspondence:
| | - Yanyun Yang
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, FL 32306, USA
| | - Zhenzhen Liu
- School of Psychology, Northeast Normal University, Changchun 130024, China
| | - Cunxian Jia
- Department of Epidemiology, School of Public Health, Cheeloo Medical College, Shandong University, Jinan 250012, China
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Longitudinal associations of the duration of mobile phone use with suicidal behavior in adolescents: The mediating role of depressive symptoms. J Affect Disord 2022; 314:365-371. [PMID: 35878828 DOI: 10.1016/j.jad.2022.07.035] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/23/2022] [Accepted: 07/17/2022] [Indexed: 01/29/2023]
Abstract
BACKGROUND Prolonged mobile phone use has been demonstrated to be associated with mental health problems and suicidal behavior in adolescents. This study examined the mediating role of depressive symptoms in the association between duration of mobile phone use (DMPU) and suicidal behavior in adolescents. METHODS A total of 6,923 participants from the Shandong Adolescent Behavior & Health Cohort (SABHC) were included in the analysis. Participants completed a self-administered questionnaire to assess DMPU on weekdays and weekends, mental disorders, insomnia symptoms, depressive symptoms, suicidal behavior (thought, plan, or attempt), and family demographics in November-December 2015. One year later, a follow-up survey was conducted to ask participants to report their depressive symptoms and suicidal behavior. Path analyses with logistic regressions were performed to examine the mediating role of depressive symptoms in the DMPU-suicidal behavior link. RESULTS Of the sample, mean age was 14.58 (SD = 1.45) and 3,455 (49.9 %) were female at baseline. 12.12 % of participants reported having ever suicidal behavior during the past 12 months at baseline, and 10.63 % reported having ever suicidal behavior during 1-year follow-up. Path analyses showed that the depressive symptoms played a partial mediating role in the association of DMPU on weekdays and weekends with subsequent suicidal behavior. After controlling for covariates, depressive symptoms accounted for 33.6 % and 58.6 % of the total effect of DMPU on weekdays and weekends on suicidal behavior, respectively. LIMITATION All variables were measured based on self-report. CONCLUSIONS The link between DMPU and suicidal behavior was partially mediated by depressive symptoms. Prolonged mobile phone use and depressive symptoms should be assessed and intervened to prevent suicidal behavior in adolescents.
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16
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A longitudinal study of bidirectional associations between frequent pain and insomnia symptoms in adolescents. Sleep Health 2022; 8:467-474. [PMID: 35872148 DOI: 10.1016/j.sleh.2022.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/25/2022] [Accepted: 05/28/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Chronic pain and insomnia symptoms are prevalent in adolescents. This study examined the prospective associations between pain and insomnia symptoms in a large sample of adolescents. METHODS A total of 7072 adolescents (mean age = 14.6 years) participated in a longitudinal study of behavior and health in Shandong, China. A baseline survey was conducted in November-December of 2015, and a follow-up survey was conducted one year later. A self-administered questionnaire was used to assess headache, stomachache, other nonspecific pain, depression, substance use, and family environment. The Youth Self-Rating Insomnia Scale was used to measure insomnia symptoms. RESULTS At baseline and 1-year follow-up, frequent pain was reported by 8.4% and 7.8% of the sample, respectively; moderate to severe insomnia symptoms were reported by 15.2% and 14.8%, respectively. Logistic regression analyses showed that frequent pain at baseline was significantly associated with increased odds of incident insomnia symptoms at 1-year follow-up (odds ratio [OR] = 1.70, 95% confidence interval [CI] = 1.23-2.34) while adjusting for adolescent and family covariates. On the other hand, insomnia symptoms at baseline were significantly associated with increased odds of incident frequent pain at 1-year follow-up (OR = 2.00, 95% CI = 1.50-2.68). The 3 types of pain (ie, headache, stomachache, and other nonspecific pain) had similar associations with insomnia symptoms. CONCLUSIONS The findings suggest that the associations between frequent pain and insomnia are bidirectional, independent of multiple adolescent and family covariates. These findings stress the importance of assessment and management of both pain and insomnia symptoms in adolescents in routine clinical practice and school-based intervention programs.
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Goldstein TR, Franzen PL. A Comprehensive Review of the Literature on Sleep Difficulties and Suicidality in Youth to Inform an Integrative Developmental Model and Future Directions. CURRENT SLEEP MEDICINE REPORTS 2022; 8:1-19. [PMID: 36274826 PMCID: PMC9586157 DOI: 10.1007/s40675-022-00222-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2022] [Indexed: 12/16/2022]
Abstract
Purpose of Review Suicide is currently the second leading cause of death among youth. Identification of modifiable near-term risk factors can inform suicide prevention strategies. One promising, readily assessed factor is sleep. We critically review the literature on sleep and suicidal thoughts and behaviors among youth. Recent Findings Most studies examining the youth sleep-suicidality relationship are from epidemiological samples in which both sleep problems and suicidality were assessed over variable timeframes using limited items from scales not designed to measure these constructs. Nonetheless, these data overwhelmingly support an association between suicidality and a range of sleep difficulties (e.g., insomnia, short/long sleep, weekend oversleep), above and beyond depressive symptoms. Limited studies include clinical samples or prospective designs. We review potential mechanisms and present a developmentally-informed integrative model. Summary Literature supports a clear association between sleep difficulties and youth suicidality. Future directions include prospective longitudinal studies and targeted prevention efforts.
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Affiliation(s)
- Tina R Goldstein
- Western Psychiatric Hospital and the Center for Sleep and Circadian Science, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Peter L Franzen
- Western Psychiatric Hospital and the Center for Sleep and Circadian Science, University of Pittsburgh School of Medicine, Pittsburgh, PA
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18
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Hu L, Liu ZZ, Wang ZY, Jia CX, Liu X. Associations between pain and depressive symptoms: A longitudinal study of Chinese adolescents. J Affect Disord 2022; 299:675-681. [PMID: 34953924 DOI: 10.1016/j.jad.2021.12.095] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 12/13/2021] [Accepted: 12/20/2021] [Indexed: 11/19/2022]
Abstract
AIMS Pain and depressive symptoms are prevalent in adolescents. Data on the association between pain and depressive symptoms in the general adolescent population are limited. The purpose of this study was to investigate the prospective associations of headache, stomachache, and other nonspecific pain with depressive symptoms in a large sample of Chinese adolescents. METHODS A total of 7072 adolescents who participated in the baseline survey and were followed up 1 year later were included in the prospective analysis. Participants completed a self-administered questionnaire to assess three types of pain (headache, stomachache, and other nonspecific pain) and demographics. Depressive symptoms were assessed by the Center for Epidemiology Studies Depression Scale. Logistic regression models were conducted to evaluate the associations between pain and depressive symptoms. RESULTS The prevalence and incidence rates of depressive symptoms significantly increased with elevated pain frequencies. After adjusting for insomnia symptoms and other adolescent and family covariates, frequent headache (OR=2.39, 95% CI =1.37-4.16) and other nonspecific pain (sometimes pain: OR=1.57, 95% CI =1.14-2.15; frequent pain: OR=2.78, 95% CI =1.33-5.82) were significantly associated with increased risk of depressive symptoms 1 year later. Study limitation: Pain and depressive symptoms were self-reports. CONCLUSIONS The findings suggest that frequent pain is associated with subsequent depressive symptoms. Further research is needed to determine the causal relationship between pain and depressive symptoms in adolescents.
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Affiliation(s)
- Lei Hu
- Shandong Mental Health Center, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Zhen-Zhen Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China; School of Psychology, Northeast Normal University, Changchun, China
| | - Zi-Yang Wang
- School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, 19104, United States.
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19
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Pozuelo JR, Desborough L, Stein A, Cipriani A. Systematic Review and Meta-analysis: Depressive Symptoms and Risky Behaviors Among Adolescents in Low- and Middle-Income Countries. J Am Acad Child Adolesc Psychiatry 2022; 61:255-276. [PMID: 34015483 DOI: 10.1016/j.jaac.2021.05.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 03/24/2021] [Accepted: 05/06/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Several studies conducted in high-income countries have found an association between depressive symptoms and risky behaviors among adolescents. Evidence from low- and middle-income countries (LMICs), where 90% of the world's adolescents live, remains scarce. This meta-analysis systematically reviewed evidence examining the association between depressive symptoms and risky behaviors among adolescents in LMICs. METHOD Fifteen electronic databases were searched for published or unpublished cohort and case-control studies about adolescents in LMICs. The primary outcome was the association (odds ratio [OR]) between depressive symptoms and risky sexual behavior and substance use. Secondary outcomes included delinquency, adverse school behavior, self-harm, and suicidal behavior. ORs from all studies were pooled using the random-effects model. Quality of studies was assessed using the Newcastle-Ottawa scale, and strength of the overall body of evidence was assessed using Grading of Recommendations, Assessment, Development and Evaluation. RESULTS Searches yielded 31,148 potentially relevant studies. After screening, 33 studies were included in the systematic review, of which 30 comprised the meta-analysis. Studies encompassed 35,918 adolescents living in 17 LMICs: 5 from Africa, 7 from Asia, and 5 from Latin America and the Caribbean. Adolescents with depressive symptoms were more likely to engage in risky sexual behavior (OR 1.3 95% CI 1.1-1.5) and substance use (OR 1.8, 95% CI 1.4-2.2) compared with nondepressed adolescents. Results for secondary outcomes showed a similar pattern, with higher delinquency (OR 3.2, 95% CI 1.8-5.6), self-harm (OR 4.4, 95% CI 1.3-14.4), and suicidal behavior (OR 6.6, 95% CI 2.3-18.9) among adolescents with depression compared with healthy adolescents. CONCLUSION This study suggests that adolescents with depression in LMICs carry a double burden: depression and increased risk of engaging in risky behaviors. This combination may lead to further psychological and physical health problems that persist over the life course and may impose a health burden on society as a whole. Taken together, these findings highlight the urgent need for scalable and sustainable approaches to prevent and/or treat depression among adolescents in resource-poor settings.
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Affiliation(s)
- Julia Ruiz Pozuelo
- University of Oxford, United Kingdom; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), University of Witwatersrand, Johannesburg, South Africa.
| | - Lucy Desborough
- Cambridgeshire and Peterborough NHS Foundation Trust, Fulbourn Hospital, Cambridge, Cambridgeshire, United Kingdom
| | - Alan Stein
- University of Oxford, United Kingdom; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), University of Witwatersrand, Johannesburg, South Africa
| | - Andrea Cipriani
- University of Oxford, United Kingdom; Oxford Health National Health Service Foundation Trust, Warneford Hospital, Oxford, United Kingdom
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20
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Li D, Yang R, Hu J, Xue Y, Huang X, Wan Y, Fang J, Zhang S. Patterns of six behaviors and psychosomatic symptoms in adolescents: A six-province study in China. J Affect Disord 2022; 297:593-601. [PMID: 34718040 DOI: 10.1016/j.jad.2021.10.118] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 10/21/2021] [Accepted: 10/25/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Psychosomatic symptoms are often related with behaviors. However, the association between different behaviors and their latent patterns and psychosomatic health status is unclear. Current study aimed to identify the patterns of six behaviors and explore the association between different patterns and psychosomatic symptoms in a school-based sample of Chinese adolescents. METHODS From November 2015 to January 2016, the study enrolled 22,628 students from six cities in China (15.36 ± 1.79 years). Six behaviors [unintentional injury (UI), non-suicidal self-injury (NSSI), suicidal behaviors (SB), drinking, smoking, screen time (ST)] and psychosomatic symptoms (psychological and physical symptoms) were measured by self-report validated questionnaires. RESULTS Six behaviors were all related to psychosomatic symptoms, among which SB was the strongest. Four patterns of behaviors were be identified as follows: low-risk pattern (64.0%), substance use pattern (4.5%), injury pattern (28.8%) and high-risk pattern (2.7%). Logistic regression analysis of psychological symptoms indicated that compared with low-risk pattern, high-risk pattern had the highest risk, followed by injury pattern, substance use pattern showed the lowest risk. Compared with low-risk pattern, the results of physical symptoms suggested the degree of risk was high-risk pattern, injury pattern and substance use pattern, respectively. LIMITATIONS Cross-sectional data were used in the study that could not evaluate causal relationships between six behaviors and psychosomatic symptoms. CONCLUSIONS Six behaviors and their latent patterns are related to psychosomatic symptoms among Chinese adolescents differently, so different intervention and prevention protocol need to be taken for different patterns of adolescents.
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Affiliation(s)
- Danlin Li
- MOE Key Laboratory of Population Health across Life Cycle/Anhui Provincial Key Laboratory of Population Health and Aristogenics, and Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 81th Meishan Road, Hefei, Anhui 230032, PR China; School of Public Health, Medical College of Soochow University, Suzhou industrial park, 199th Renai Road, Suzhou, Jiangsu 215123, PR China
| | - Rong Yang
- MOE Key Laboratory of Population Health across Life Cycle/Anhui Provincial Key Laboratory of Population Health and Aristogenics, and Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 81th Meishan Road, Hefei, Anhui 230032, PR China; Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, 44th Wenhuaxi Road, Jinan, Shandong 250000, PR China
| | - Jie Hu
- MOE Key Laboratory of Population Health across Life Cycle/Anhui Provincial Key Laboratory of Population Health and Aristogenics, and Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 81th Meishan Road, Hefei, Anhui 230032, PR China
| | - Yanni Xue
- MOE Key Laboratory of Population Health across Life Cycle/Anhui Provincial Key Laboratory of Population Health and Aristogenics, and Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 81th Meishan Road, Hefei, Anhui 230032, PR China
| | - Xuexue Huang
- MOE Key Laboratory of Population Health across Life Cycle/Anhui Provincial Key Laboratory of Population Health and Aristogenics, and Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 81th Meishan Road, Hefei, Anhui 230032, PR China
| | - Yuhui Wan
- MOE Key Laboratory of Population Health across Life Cycle/Anhui Provincial Key Laboratory of Population Health and Aristogenics, and Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 81th Meishan Road, Hefei, Anhui 230032, PR China
| | - Jun Fang
- MOE Key Laboratory of Population Health across Life Cycle/Anhui Provincial Key Laboratory of Population Health and Aristogenics, and Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 81th Meishan Road, Hefei, Anhui 230032, PR China; Faculty of Pharmaceutical Science, Sojo University, Ikeda 4-22-1, Kumamoto 860-0082, Japan.
| | - Shichen Zhang
- MOE Key Laboratory of Population Health across Life Cycle/Anhui Provincial Key Laboratory of Population Health and Aristogenics, and Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 81th Meishan Road, Hefei, Anhui 230032, PR China; School of Public Health and Health Management, Anhui Medical College, No 632 Furong Road, Hefei, Anhui 230601, PR China.
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21
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Tereshchenko SY, Shubina MV, Semenova NB, Evert LS, Gorbacheva NN. The relationship between internet addiction and sleep disorders in adolescents of Central Siberia in different types of consumed content. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:58-64. [PMID: 35759568 DOI: 10.17116/jnevro202212205258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- S Y Tereshchenko
- Krasnoyarsk Scientific Center of the Siberian Branch - Research Institute for Medical Problems in the North, Krasnoyarsk, Russia
| | - M V Shubina
- Krasnoyarsk Scientific Center of the Siberian Branch - Research Institute for Medical Problems in the North, Krasnoyarsk, Russia
| | - N B Semenova
- Krasnoyarsk Scientific Center of the Siberian Branch - Research Institute for Medical Problems in the North, Krasnoyarsk, Russia
| | - L S Evert
- Krasnoyarsk Scientific Center of the Siberian Branch - Research Institute for Medical Problems in the North, Krasnoyarsk, Russia
| | - N N Gorbacheva
- Krasnoyarsk Scientific Center of the Siberian Branch - Research Institute for Medical Problems in the North, Krasnoyarsk, Russia
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22
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Sleep problems predict next-day suicidal thinking among adolescents: A multimodal real-time monitoring study following discharge from acute psychiatric care. Dev Psychopathol 2021. [DOI: 10.1017/s0954579421000699] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
AbstractSuicidal thoughts and behaviors (STBs) are major public health concerns among adolescents, and research is needed to identify how risk is conferred over the short term (hours and days). Sleep problems may be associated with elevated risk for STBs, but less is known about this link in youth over short time periods. The current study utilized a multimodal real-time monitoring approach to examine the association between sleep problems (via daily sleep diary and actigraphy) and next-day suicidal thinking in 48 adolescents with a history of STBs during the month following discharge from acute psychiatric care. Results indicated that specific indices of sleep problems assessed via sleep diary (i.e., greater sleep onset latency, nightmares, ruminative thoughts before sleep) predicted next-day suicidal thinking. These effects were significant even when daily sadness and baseline depression were included in the models. Moreover, several associations between daily-level sleep problems and next-day suicidal thinking were moderated by person-level measures of the construct. In contrast, sleep indices assessed objectively (via actigraphy) were either not related to suicidal thinking or were related in the opposite direction from hypothesized. Together, these findings provide some support for sleep problems as a short-term risk factor for suicidal thinking in high-risk adolescents.
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23
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Liu X, Liu ZZ, Jia CX. Repeat self-harm among Chinese adolescents: 1-year incidence and psychosocial predictors. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1979-1992. [PMID: 33861354 DOI: 10.1007/s00127-021-02085-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 04/07/2021] [Indexed: 12/28/2022]
Abstract
PURPOSE Self-harm in adolescents is prevalent and is the most significant predictor of future self-harm and suicide. Longitudinal data on the incidence and predictors of repeat self-harm in the general population of adolescents are limited. This study investigated 1-year incidence and psychosocial predictors of repeat self-harm in Chinese adolescents. METHODS Shandong Adolescent Behavior and Health Cohort is a longitudinal study of behavior and health in adolescents in Shandong Province, China. Of 7072 participants who were assessed in 2015 and again 1 year later in 2016, 1879 reported a history of self-harm at the baseline survey and were included for this analysis. A self-administered structured questionnaire was used to assess behavioral and emotional problems, sleep, life stress, previous history of self-harm and suicidal thought, and family factors at baseline and self-harm at 1-year follow-up. RESULTS Mean age of the sample was 14.86 (SD 1.36) years and 54.6% were female. At 1-year follow-up, 22.1% participants engaged in repeat self-harm. Multiple logistic regression analyses showed that female gender (OR 1.45, 95% CI 1.11-1.89), alcohol use (OR 1.95, 95% CI 1.48-2.57), frequent nightmares (OR 1.61, 95% CI 1.14-2.28), elevated depression score (OR 1.59, 95% CI 1.05-2.42), and prior suicidal thought (OR 1.79, 95% CI 1.37-2.34) were independently and significantly associated with an increased risk of repeat self-harm. CONCLUSION More than one in five Chinese adolescents who had a history of self-harm engaged in self-harm at 1-year follow-up. Multiple psychosocial factors including female gender, alcohol use, frequent nightmares, depression, and prior suicidal thought appeared to be significant predictors of repeat self-harm. Our findings highlight the importance of comprehensive psychosocial assessment and intervention of repeat self-harm in adolescents.
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Affiliation(s)
- Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, 19104, USA.
| | - Zhen-Zhen Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Psychology, REACH Institute, Arizona State University, Tempe, AZ, USA
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
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24
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Tereshchenko S, Kasparov E, Smolnikova M, Shubina M, Gorbacheva N, Moskalenko O. Internet Addiction and Sleep Problems among Russian Adolescents: A Field School-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910397. [PMID: 34639694 PMCID: PMC8507923 DOI: 10.3390/ijerph181910397] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/27/2021] [Accepted: 09/29/2021] [Indexed: 01/09/2023]
Abstract
This study aims to establish a link between disturbances in the night sleep habitus, quality of sleep, and daytime sleepiness in adolescents with Internet addiction and different types of content consumed. Methods: This is a cross-sectional observational study of a school sample in three large cities in Central Siberia. 4615 schoolchildren of 12–18 years old were examined. The Russian-language versions of the Chen Internet Addiction Scale, the Game Addiction Scale for Adolescents, and the Social Media Disorder Scale were used to identify Internet addiction. Questions from the Pittsburgh Sleep Quality Index questionnaire were used to assess nighttime sleep. Daytime sleepiness was assessed using the Pediatric Daytime Sleepiness Scale questionnaire. Results: Adolescents with Internet addiction go to bed and wake up late; they are characterized by a decrease in the duration of nighttime sleep, an increase in sleep onset latency, and frequent nighttime awakenings, as well as more pronounced daytime sleepiness. Among the sleep parameters studied, the indicators of daytime sleepiness and night awakening scales have the highest effect size in Internet-addicted adolescents, regardless of the media consumed. Conclusion: Internet-addicted adolescents are characterized by significant disturbances in the quality of nighttime sleep and excessive daytime sleepiness, which requires appropriate psychological correction.
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25
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Hamilton JL, Lee W. Associations Between Social Media, Bedtime Technology Use Rules, and Daytime Sleepiness Among Adolescents: Cross-sectional Findings From a Nationally Representative Sample. JMIR Ment Health 2021; 8:e26273. [PMID: 34524967 PMCID: PMC8482309 DOI: 10.2196/26273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 04/16/2021] [Accepted: 05/04/2021] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Social media use is associated with poor sleep among adolescents, including daytime sleepiness, which affects adolescents' mental health. Few studies have examined the associations among specific aspects of social media, such as frequency of checking and posting, perceived importance of social media for social belonging, and daytime sleepiness. Identifying whether certain adolescents are more at risk or protected from the effects of social media on sleepiness may inform future interventions for social media, sleep, and mental health. OBJECTIVE This study aims to examine the association between social media use frequency and importance, daytime sleepiness, and whether the perceived importance of social media for social interactions and parental rules around bedtime technology moderated these relationships. METHODS This cross-sectional survey study was conducted with a sample of 4153 adolescents from across the United States. Qualtrics was used to collect data via panel recruitment from a national sample representing the US demographics of teens aged 12 to 17 years. Participants completed measures of daytime sleepiness, frequency of social media checking and posting, and the importance of social media for social interactions. Parents reported whether they had a household rule around bedtime media and screen use. Hierarchical regressions and moderation analyses were conducted, covarying for age, gender, and age at first smartphone use. RESULTS Participants had a mean age of 14.64 (SD 1.66) years in grades 6 to 12, 46.45% (1929/4153) identified as female, and 67.93% (2821/4153) identified as White. The results indicated that adolescents who posted (B=0.70, SE 0.04; P<.001) or checked (B=0.76, SE 0.04; P<.001) social media more frequently or who perceived social media to be more important for social belonging (B=0.36, SE 0.02; P<.001) had higher levels of daytime sleepiness. Moderation analyses indicated that the relationship between social media use frequency and daytime sleepiness was exacerbated by higher levels of perceived social media importance (B=0.04, SE 0.01; P<.001). Adolescents without household rules around bedtime technology use were more likely to be affected by social media checking (B=-0.34, SE 0.09; P<.001) and importance (B=-0.16, SE 0.04; P<.001) on daytime sleepiness. CONCLUSIONS The findings suggest that social media use frequency and perceived importance of social interactions are associated with daytime sleepiness among adolescents. It is important to consider youth's perceptions of social media when assessing the potential effects of social media use frequency on youth well-being. Furthermore, youth who did not have parental rules around bedtime technology use were most likely to be affected by social media use and perceived importance. The findings may extend to other mental health outcomes and may guide future prevention and intervention programs designed to improve social media use, sleep, and mental health.
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Affiliation(s)
| | - Woanjun Lee
- Department of Psychology, Rutgers University, Piscataway, NJ, United States
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26
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Guo L, Wang W, Wang T, Zhao M, Wu R, Lu C. The Longitudinal Association between Sleep Duration and Suicidal Behavior among Chinese Adolescents: The Role of Nonmedical Use of Prescription Drug. Behav Sleep Med 2021; 19:589-601. [PMID: 32967469 DOI: 10.1080/15402002.2020.1822361] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE/BACKGROUND Abnormal sleep and nonmedical use of prescription drugs are known to be factors associated with suicidal behavior, but the nature of the association between weekday sleep duration and suicidal behavior has not been elucidated. Nonmedical use of prescription drugs may play a mediator role in the association mentioned above. PARTICIPANTS There were a total of 3,273 high school students interviewed at baseline with a response rate of 96.8% and followed up at one year (retention rate, 96.1%). The mean (SD) age of the students was 13.7 (1.0) years. METHODS Data were drawn from the longitudinal data of the School-based Chinese Adolescents Health Survey. A total of 12 high schools were selected in Guangzhou. Suicidal behavior, weekday sleep duration, and nonmedical use of prescription drugs were measured. RESULTS Sleeping < 7 hours/day at time 0 was positively associated with suicidal ideation (Adjusted odds ratio [AOR] = 1.51, 95% CI = 1.21-1.89) and suicide attempts (AOR = 2.35, 95% CI = 1.02-5.38) at time 1. The mediation analyses showed that baseline opioids misuse or sedatives misuse partially mediated the associations of baseline short weekday sleep duration with suicidal ideation and suicide attempts at one-year follow-up. CONCLUSIONS Baseline short weekday sleep duration was positively associated with subsequent suicidal ideation and suicide attempts, and nonmedical use of opioids or sedatives partially mediated the associations mentioned above. Suicidal behavior can be prevented, short weekday sleep duration and nonmedical use of prescription drugs may be risk factors for suicidal behavior, and the respective roles of these factors are needed to be better understood.
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Affiliation(s)
- Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Tian Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Meijun Zhao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Ruipeng Wu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, People's Republic of China
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Jeong H, Cho SJ, Jeon S, Lee J, Lee YJ, Kim SJ. Association between snoring and depressive symptoms in adolescents. J Psychiatr Res 2021; 140:165-171. [PMID: 34116442 DOI: 10.1016/j.jpsychires.2021.05.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 05/13/2021] [Accepted: 05/29/2021] [Indexed: 11/19/2022]
Abstract
While previous studies have suggested that snoring may be associated with depressive symptoms and suicidality in adults and preschool children, there have been no investigations in non-clinical adolescent populations. This study aimed to demonstrate the association between snoring and depressive symptoms/suicidality in adolescents. This survey study recruited 8530 students (grades 7-11) and examined depressive symptoms, suicidality, snoring frequency, daytime sleepiness, sleep duration, and presence of insomnia by questionnaires. Correlation analyses, multiple linear regression analyses and mediation analyses were performed to determine the association between snoring frequency and depressive symptoms/suicidality. The study population included 8080 students (16.73 ± 1.09 years old). Snoring frequency was positively correlated with depressive symptoms and suicidality. Snoring frequency was associated with depressive symptoms and suicidality when adjusted for age and sex, and the association remained significant after additionally adjusting for sleep duration, insomnia, and daytime sleepiness. When depressive symptoms were included as a predictor of suicidality, snoring frequency showed no significant predictive value. Mediation analysis confirmed that depressive symptoms mediate the association between snoring frequency and suicidality. Our findings suggest that self-reported complaints of snoring are associated with increased depressive symptoms and suicidality in adolescents independently of sleep duration, insomnia, and daytime sleepiness, and the connection between snoring and suicidality is mediated by depressive symptoms. These data underscore the importance of identifying snorers among adolescents and screening for depression and suicidal ideation in this population.
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Affiliation(s)
- Hyunwoo Jeong
- Geumsan-gun Public Health Center, Geumsan, Republic of Korea
| | - Seong-Jin Cho
- Department of Psychiatry, Gachon University of Medicine and Science, Incheon, Republic of Korea
| | - Sehyun Jeon
- Department of Psychiatry, Korea University College of Medicine, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Jooyoung Lee
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Yu Jin Lee
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Seog Ju Kim
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea.
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28
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Liu X, Liu ZZ, Yang Y, Jia CX. Associations of frequent pain symptoms with excessive daytime sleepiness in adolescents: a longitudinal study. J Clin Sleep Med 2021; 17:2415-2423. [PMID: 34170226 DOI: 10.5664/jcsm.9444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Pain symptoms, sleep disturbance, and daytime sleepiness are common in adolescents. This study examined the cross-sectional and prospective associations between pain symptoms and excessive daytime sleepiness (EDS) in a large sample of adolescents. METHODS Participants were 7,072 adolescents (mean age = 14.6 years) in a follow-up study of behavior and health in Shandong, China. A self-administered structured questionnaire was used to assess pain symptoms (headache, stomachache, and other general pain), body weight and height, sleep, anxiety/depression, substance use, and family environment in November-December in 2015 and one year later. The Chinese adolescent daytime sleepiness scale (CADSS) was used to measure daytime sleepiness. RESULTS Of the sample, 19.8% and 23.2% had moderate or severe EDS at baseline and at 1-year follow-up, respectively. The prevalence and 1-year incidence rates of EDS significantly increased with the frequencies of pain symptoms. Frequent pain was significantly associated with increased risk of EDS at baseline (OR=2.01, 95% CI=1.56-2.59), incident EDS (OR=1.41, 95% CI=1.03-1.93), and persistent EDS (OR=2.17, 95% CI=1.52-3.09) while adjusting for adolescent and family covariates, including anxiety/depression, nocturnal sleep duration, insomnia symptoms, frequent snoring, body mass index, and hypnotic use. Similar associations were observed across headache, stomachache, and other pain. CONCLUSIONS Frequent pain is significantly and independently associated with increased risk of EDS. Our findings suggest that assessing and treating pain symptoms is important to improve healthy sleep and reduce risk of EDS in adolescents. Further research is needed to understand the underlying psychological and neurobiological mechanisms between pain and daytime sleepiness in adolescents.
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Affiliation(s)
- Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA
| | - Zhen-Zhen Liu
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China.,Department of Psychology, REACH Institute, Arizona State University, Tempe, AZ
| | - Yanyun Yang
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, FL
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
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29
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Geoffroy PA, Oquendo MA, Courtet P, Blanco C, Olfson M, Peyre H, Lejoyeux M, Limosin F, Hoertel N. Sleep complaints are associated with increased suicide risk independently of psychiatric disorders: results from a national 3-year prospective study. Mol Psychiatry 2021; 26:2126-2136. [PMID: 32355334 DOI: 10.1038/s41380-020-0735-3] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 04/06/2020] [Accepted: 04/14/2020] [Indexed: 12/21/2022]
Abstract
Prior research suggests that sleep disturbances are associated with increased risk of suicide. However, sleep disturbances are associated with a wide range of psychiatric disorders, and it is unknown whether this association is independent of psychopathology. In a large nationally representative prospective survey, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), we used structural equation modeling to examine the shared and specific effects of three sleep complaints (i.e., trouble falling asleep, early morning awakening, and hypersomnia) on the 3-year occurrence of attempting suicide. Because psychiatric disorders increase the risk of suicide attempt almost exclusively through a general psychopathology factor representing their shared effect, covariates included that factor, prior history of suicide attempt, and a wide range of sociodemographic and clinical characteristics. The 3-year prevalence rate of suicide attempt was 0.6% (n = 241). Compared with participants who did not attempt suicide between the two waves, those who did reported significantly more frequently having trouble falling asleep (44.6% vs. 16.6%), early morning awakening (38.9% vs. 12.7%), and hypersomnia (35.0% vs. 10.7%). Following adjustments, effects of sleep complaints on this risk were significant and exerted almost exclusively through a general sleep complaints factor representing the shared effect across all sleep complaints. There were no residual associations of any individual sleep complaint with attempting suicide above that association. Sleep complaints are associated with an increased risk of attempting suicide independently of psychopathology, and should be included in suicide risk assessments as these symptoms may provide targets for reducing the risks of suicidal behaviors.
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Affiliation(s)
- Pierre A Geoffroy
- Paris Diderot University-Paris VII, 5 Rue Thomas Mann, 75013, Paris, France. .,Université de Paris, NeuroDiderot, Inserm, F-75019, Paris, France. .,University Hospital Bichat-Claude Bernard, 46 rue Henri Huchard, 75018, Paris, France.
| | - Maria A Oquendo
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Philippe Courtet
- INSERM, U1061, Neuropsychiatry, University Montpellier, Montpellier, France.,Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, Montpellier, France
| | - Carlos Blanco
- Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, MD, USA
| | - Mark Olfson
- Department of Psychiatry, New York State Psychiatric Institute/Columbia University, New York, NY, 10032, USA
| | - Hugo Peyre
- Assistance Publique-Hôpitaux de Paris, Robert Debré Hospital, Child and Adolescent Psychiatry Department, Paris, France.,Cognitive Sciences and Psycholinguistic Laboratory, Ecole Normale Supérieure, Paris, France
| | - Michel Lejoyeux
- Paris Diderot University-Paris VII, 5 Rue Thomas Mann, 75013, Paris, France.,University Hospital Bichat-Claude Bernard, 46 rue Henri Huchard, 75018, Paris, France
| | - Frédéric Limosin
- Cognitive Sciences and Psycholinguistic Laboratory, Ecole Normale Supérieure, Paris, France.,Centre Ressource Régional de Psychiatrie du Sujet Agé (CRRPSA), Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, DMU Psychiatrie et Addictologie, AP-HP.Centre-Université de Paris, Paris, France.,Faculté de médecine Paris Descartes, Université de Paris, Paris, France.,Inserm U1266, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
| | - Nicolas Hoertel
- Cognitive Sciences and Psycholinguistic Laboratory, Ecole Normale Supérieure, Paris, France.,Centre Ressource Régional de Psychiatrie du Sujet Agé (CRRPSA), Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, DMU Psychiatrie et Addictologie, AP-HP.Centre-Université de Paris, Paris, France.,Faculté de médecine Paris Descartes, Université de Paris, Paris, France.,Inserm U1266, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
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30
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Hu T, Wang Y, Lin L, Tang W. The mediating role of daytime sleepiness between problematic smartphone use and post-traumatic symptoms in COVID-19 home-refined adolescents. CHILDREN AND YOUTH SERVICES REVIEW 2021; 126:106012. [PMID: 33846662 PMCID: PMC8028598 DOI: 10.1016/j.childyouth.2021.106012] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 01/23/2021] [Accepted: 04/06/2021] [Indexed: 02/08/2023]
Abstract
Background COVID-19 was first recognized in late 2019 in China, at which time school closures forced most students to isolate at home or maintain social distance, both of which increased smartphone use, daytime sleepiness and post traumatic disorder (PTSD) risks. However, to date, no research has fully explored these behavioral risks or the consequences. Methods Two thousand and ninety home-confined students from two Chinese high schools participated in an online-based questionnaire battery that assessed their sociodemographic characteristics, COVID-19 related exposures, daytime sleepiness, problematic smartphone use, and PTSD. The subsequent data were subjected to mediation analysis, and structural equation models (SEM) were employed to explore the variable relationships. Results The problematic smartphone use, daytime sleepiness and PTSD prevalence were respectively 16.4%, 20.2% and 6.9%. The number of COVID-19 related exposure was directly associated with problematic smartphone use and PTSD symptoms. Problematic smartphone use was found to be a mediator between COVID-19 related exposure and PTSD symptoms, and daytime sleepiness was found to partially mediate the associations between problematic smartphone use and PTSD. Conclusions The more exposure associated with the pandemic, the more psychological and behavioral problems the adolescents had. The relatively high rate of problematic smartphone use in home isolated adolescents possibly increased the risk of daytime sleepiness and psychological problems. Therefore, targeted improvements are needed to reduce the risk of psychological problems and daytime sleepiness in adolescents.
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Affiliation(s)
- Tao Hu
- Department of Psychology, Chengdu Normal University, Chengdu, China
| | - Ying Wang
- Department of Psychology, Chengdu Normal University, Chengdu, China
| | - Ling Lin
- Department of Psychology, Chengdu Normal University, Chengdu, China
| | - Wanjie Tang
- Centre for Educational and Health Psychology, Sichuan University, Chengdu, China.,Mental Health Center, State Key Lab of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
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31
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Lei B, Zhang J, Chen S, Chen J, Yang L, Ai S, Chan NY, Wang J, Dai XJ, Feng H, Liu Y, Li SX, Jia F, Wing YK. Associations of sleep phenotypes with severe intentional self-harm: a prospective analysis of the UK Biobank cohort. Sleep 2021; 44:6153445. [PMID: 33640972 DOI: 10.1093/sleep/zsab053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 01/06/2021] [Indexed: 11/12/2022] Open
Abstract
STUDY OBJECTIVES We aimed to investigate the prospective associations of sleep phenotypes with severe intentional self-harm (ISH) in middle-aged and older adults. METHODS A total of 499,159 participants (mean age: 56.55 ± 8.09 years; female: 54.4%) were recruited from the UK Biobank between 2006 and 2010 with follow-up until February 2016 in this population-based prospective study. Severe ISH was based on hospital inpatient records or a death cause of ICD-10 codes X60-X84. Patients with hospitalized diagnosis of severe ISH before the initial assessment were excluded. Sleep phenotypes, including sleep duration, chronotype, insomnia, sleepiness, and napping, were assessed at the initial assessments. Cox regression analysis was used to estimate temporal associations between sleep phenotypes and future risk of severe ISH. RESULTS During a follow-up period of 7.04 years (SD: 0.88), 1,219 participants experienced the first hospitalization or death related to severe ISH. After adjusting for demographics, substance use, medical diseases, mental disorders, and other sleep phenotypes, short sleep duration (HR: 1.50, 95% CI: 1.23-1.83, P < .001), long sleep duration (HR: 1.56, 95% CI: 1.15-2.12, P = .004), and insomnia (usually: HR: 1.57, 95% CI: 1.31-1.89, P < .001) were significantly associated with severe ISH. Sensitivity analyses excluding participants with mental disorders preceding severe ISH yielded similar results. CONCLUSION The current study provides the empirical evidence of the independent prediction of sleep phenotypes, mainly insomnia, short and long sleep duration, for the future risk of severe ISH among middle-aged and older adults.
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Affiliation(s)
- Binbin Lei
- Li Chiu Kong Family Sleep assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Jihui Zhang
- Li Chiu Kong Family Sleep assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.,Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Sijing Chen
- Li Chiu Kong Family Sleep assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Jie Chen
- Li Chiu Kong Family Sleep assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Lulu Yang
- Li Chiu Kong Family Sleep assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.,Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Sizhi Ai
- Li Chiu Kong Family Sleep assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Jing Wang
- Li Chiu Kong Family Sleep assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Xi-Jian Dai
- Li Chiu Kong Family Sleep assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Hongliang Feng
- Li Chiu Kong Family Sleep assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Yaping Liu
- Li Chiu Kong Family Sleep assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Shirley Xin Li
- Department of Psychology, The University of Hong Kong, Hong Kong SAR, China.,The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - Fujun Jia
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Yun-Kwok Wing
- Li Chiu Kong Family Sleep assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
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32
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Çaltekin I, Hamamcı M. Is working in the emergency department a risk factor for sleep disorders for healthcare workers? Sleep Sci 2021; 14:129-135. [PMID: 34381576 PMCID: PMC8340894 DOI: 10.5935/1984-0063.20200051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 09/01/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE This study aims to investigate the relationship between work-related stress and sleep disorders in healthcare personnel working in emergency department and in other departments. MATERIAL AND METHODS This cross-sectional study included 34 emergency department healthcare personnel (emergency group [EG]) and 35 healthcare personnel working in other departments (non-emergency group [NEG]) and was conducted between November 10, 2019 and March 1, 2020. All participants were administered the following questionnaires: work-related strain inventory (WRSI), Epworth sleepiness scale (ESS), Berlin questionnaire, insomnia severity index (ISI), Pittsburgh sleep quality index (PSQI), Beck depression inventory (BDI), and Beck anxiety inventory (BAI). RESULTS While the mean WRSI score of EG was 39.53±7.77, the mean WRSI score of NEG was 30.06±7.26 (t=5.236, p<0.001). According to PSQI, 79.4% of EG and 57.1% of NEG were found to have poor sleep quality (X2=3.938, df=1, p=0.047). Median PSQI overall score was 12 (IQR 25th-75th percentiles: 10-14) in EG, and 7 (IQR 25th-75th percentiles: 4-9) in NEG (U=285.5, p<0.001). While the mean anxiety score of EG was 13.35±5.70, the mean anxiety score of NEG was 9.06±6.00 (t=3.046, p=0.003). Median depression score was 12 (IQR 25th-75th percentiles: 10-16) in EG, and was 8 (IQR 25th-75th percentiles: 4-12) in NEG (U=354, p=0.004). A significant positive correlation was found between work-related strain scores and sleep quality, sleepiness, and insomnia severity scores (r=0.541, p<0.001; r=0.310, p=0.010; r=0.357, p=0.004; respectively). CONCLUSION It was determined that healthcare personnel working in the emergency department were at higher risk of developing sleep disorders compared to healthcare personnel working in other departments and that there was a significant relationship between sleep disorders and work-related stress.
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Affiliation(s)
- Ibrahim Çaltekin
- Yozgat Bozok University Faculty of Medicine, Department of
Emergency Medicine - Yozgat - Center - Turkey. ,Corresponding author: Ibrahim
Çaltekin. E-mail:
| | - Mehmet Hamamcı
- Yozgat Bozok University Faculty of Medicine, Department of
Neurology - Yozgat - Center - Turkey
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Abstract
Sleep disturbances have been linked to suicidal ideation and behaviors in adolescents. Specifically, insomnia and nightmares are associated with current suicide risk and predict future ideation. Associations between hypersomnia, sleep apnea, and suicide remain inconclusive. Potential biological mechanisms underlying these relationships include executive functioning deficits and hyperarousal. Related psychological factors may include thwarted belongingness, perceived burdensomeness, and negative appraisals. Assessing suicide risk in patients with sleep disturbances, and vice versa, is needed. Therapeutic interventions such as cognitive behavior therapy for insomnia and imagery rehearsal treatment, as well as pharmacologic treatments, show promise in treating sleep disorders and suicidal behavior.
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34
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Malheiros LEA, da Costa BGG, Lopes MVV, Chaput JP, Silva KS. Association between physical activity, screen time activities, diet patterns and daytime sleepiness in a sample of Brazilian adolescents. Sleep Med 2020; 78:1-6. [PMID: 33370617 DOI: 10.1016/j.sleep.2020.12.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 12/03/2020] [Accepted: 12/04/2020] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To examine the association between physical activity, screen time, eating habits and daytime sleepiness among Brazilian adolescents. METHODS Adolescents from three high schools (n = 876, 49.8% female, 16.4 ± 1.2 years) participated in this cross-sectional survey. Variables related to lifestyle behaviors (ie, physical activity, screen time, eating habits, sleep duration) were collected through an online questionnaire. Daytime sleepiness was assessed using the Pediatric Daytime Sleepiness Scale (PDSS). Excessive daytime sleepiness was defined as a PDSS score ≥20. RESULTS The average PDSS score was 18.9 (SD ± 4.8) points and 46.8% of adolescents were classified as having excessive daytime sleepiness. Physical activity was inversely associated with PDSS score (β = -0.29, 95% CI -0.47; -0.11). Consuming processed foods frequently (β = 1.16, 95% CI 0.85; 1.47) and using social media (β = 0.22, 95% CI 0.14; 0.30) were positively associated with PDSS score. Similar findings were observed for the odds of excessive daytime sleepiness. Physical activity was inversely associated (OR = 0.91, 95% CI 0.84; 0.99), while frequent consumption of processed foods (OR = 1.55, 95% CI 1.33; 1.82) and using social media (OR = 1.13, 95% CI 1.02; 1.24) were positively associated with excessive daytime sleepiness. CONCLUSIONS Lower physical activity level, a higher consumption processed foods, and higher social media use were associated with daytime sleepiness in this sample of Brazilian adolescents.
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Affiliation(s)
- Luís E A Malheiros
- Núcleo de Pesquisa em Atividade Física e Saúde, Universidade Federal de Santa Catarina, Florianópolis, Brazil.
| | - Bruno G G da Costa
- Núcleo de Pesquisa em Atividade Física e Saúde, Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Marcus V V Lopes
- Núcleo de Pesquisa em Atividade Física e Saúde, Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Kelly S Silva
- Núcleo de Pesquisa em Atividade Física e Saúde, Universidade Federal de Santa Catarina, Florianópolis, Brazil
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35
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Suicidal ideation among nurses: Unique and cumulative effects of different subtypes of sleep problems. J Affect Disord 2020; 276:600-607. [PMID: 32871691 DOI: 10.1016/j.jad.2020.07.095] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 06/10/2020] [Accepted: 07/05/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Nurses have high rates of sleep problems, and higher risk of suicide than the general population. However, there is no empirical evidence showing the extent to which sleep problems among nurses are related to suicidal ideation. METHODS Multistage stratified cluster sampling was performed to recruit nurses from tertiary hospitals in Shandong, China. Item 9 of the Patient Health Questionnaire-9 was used to assess suicidal ideation. The Pittsburgh Sleep Quality Index was used to assess different subtypes of sleep problems. RESULTS Overall prevalence of suicidal ideation among the sample was 10.8%. Nurses with sleep problems were at high risk for suicidal ideation (bOR = 1.79, 95% CI = 1.20-2.65). Among different sleep problem subtypes, only "cannot breathe comfortably" was independently related to suicidal ideation. Different subtypes of sleep problems had cumulative effects on suicidal ideation: the more subtypes of sleep problems nurses experienced, the higher the likelihood of suicidal ideation. LIMITATIONS The cross-sectional study design prevents inferring causation, and the use of self-report measures may lead to recall bias. Other physical/mental conditions, besides depression, were not assessed. Statistical power may have been insufficient due to the small sub-sample who reported suicidal ideation. Also, the generalizability of the results is limited, as the sample only comprised nurses in tertiary hospitals. CONCLUSIONS Nurses experiencing sleep problems were associated with increased likelihood of suicidal ideation. It may be beneficial to incorporate sleep problems into routine screening and intervention for suicide prevention in clinical practice.
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36
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Sleepiness, sleep duration, and human social activity: An investigation into bidirectionality using longitudinal time-use data. Proc Natl Acad Sci U S A 2020; 117:21209-21217. [PMID: 32817530 DOI: 10.1073/pnas.2004535117] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Daytime sleepiness impairs cognitive ability, but recent evidence suggests it is also an important driver of human motivation and behavior. We aimed to investigate the relationship between sleepiness and a behavior strongly associated with better health: social activity. We additionally aimed to investigate whether a key driver of sleepiness, sleep duration, had a similar relationship with social activity. For these questions, we considered bidirectionality, time of day, and differences between workdays and days off. Over 3 wk, 641 working adults logged their behavior every 30 min, completed a sleepiness scale every 3 h, and filled a sleep diary every morning (rendering >292,000 activity and >70,000 sleepiness datapoints). Using generalized additive mixed-effect models, we analyzed potential nonlinear relationships between sleepiness/sleep duration and social activity. Greater sleepiness predicted a substantial decrease in the probability of social activity (odds ratio 95% CI = 0.34 to 0.35 for days off), as well as a decreased duration of such activity when it did occur. These associations appear especially robust on days off and in the evenings. Social duration moderated the typical time-of-day pattern of sleepiness, with, for example, extended evening socializing associated with lower sleepiness. Sleep duration did not robustly predict next-day social activity. However, extensive social activity (>5 h) predicted up to 30 min shorter subsequent sleep duration. These results indicate that sleepiness is a strong predictor of voluntary decreases in social contact. It is possible that bouts of sleepiness lead to social withdrawal and loneliness, both risk factors for mental and physical ill health.
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37
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Harris LM, Huang X, Linthicum KP, Bryen CP, Ribeiro JD. Sleep disturbances as risk factors for suicidal thoughts and behaviours: a meta-analysis of longitudinal studies. Sci Rep 2020; 10:13888. [PMID: 32807889 PMCID: PMC7431543 DOI: 10.1038/s41598-020-70866-6] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 07/30/2020] [Indexed: 12/13/2022] Open
Abstract
In recent years, there has been a growing interest in understanding the relationship between sleep and suicide. Although sleep disturbances are commonly cited as critical risk factors for suicidal thoughts and behaviours, it is unclear to what degree sleep disturbances confer risk for suicide. The aim of this meta-analysis was to clarify the extent to which sleep disturbances serve as risk factors (i.e., longitudinal correlates) for suicidal thoughts and behaviours. Our analyses included 156 total effects drawn from 42 studies published between 1982 and 2019. We used a random effects model to analyse the overall effects of sleep disturbances on suicidal ideation, attempts, and death. We additionally explored potential moderators of these associations. Our results indicated that sleep disturbances are statistically significant, yet weak, risk factors for suicidal thoughts and behaviours. The strongest associations were found for insomnia, which significantly predicted suicide ideation (OR 2.10 [95% CI 1.83-2.41]), and nightmares, which significantly predicted suicide attempt (OR 1.81 [95% CI 1.12-2.92]). Given the low base rate of suicidal behaviours, our findings raise questions about the practicality of relying on sleep disturbances as warning signs for imminent suicide risk. Future research is necessary to uncover the causal mechanisms underlying the relationship between sleep disturbances and suicide.
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Affiliation(s)
- Lauren M Harris
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL, 32306-4301, USA.
| | - Xieyining Huang
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL, 32306-4301, USA
| | - Kathryn P Linthicum
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL, 32306-4301, USA
| | - Chloe P Bryen
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL, 32306-4301, USA
| | - Jessica D Ribeiro
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL, 32306-4301, USA
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Sleep, premenstrual mood disorder, and women’s health. Curr Opin Psychol 2020; 34:43-49. [DOI: 10.1016/j.copsyc.2019.09.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 08/05/2019] [Accepted: 09/05/2019] [Indexed: 01/20/2023]
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Liu X, Luo Y, Liu ZZ, Yang Y, Liu J, Jia CX. Prolonged Mobile Phone Use Is Associated with Poor Academic Performance in Adolescents. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2020; 23:303-311. [DOI: 10.1089/cyber.2019.0591] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yachen Luo
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, Florida, USA
| | - Zhen-Zhen Liu
- Shandong University School of Public Health, Jinan, China
| | - Yanyun Yang
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, Florida, USA
| | - Jianghong Liu
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Cun-Xian Jia
- Shandong University School of Public Health, Jinan, China
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40
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Exploring the bi-directional relationship between sleep and resilience in adolescence. Sleep Med 2020; 73:63-69. [PMID: 32791441 DOI: 10.1016/j.sleep.2020.04.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 04/19/2020] [Accepted: 04/20/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The study examined whether overall sleep quality and the sleep components comprising the Pittsburgh Sleep Quality Index (PSQI) have a bi-directional relationship with resilience among adolescents, after adjusting for sex, age, depression, and socioeconomic status, and investigated which sleep components have a stronger effect on resilience. METHODS A total of 1299 students (58% females; mean age, 15.79 years) participated at baseline, with 840 finishing all four study waves over the course of 24 months. Data were collected through questionnaires, including socio-demographics, the Pittsburgh Sleep Quality Index, Patient Health Questionnaire 9-item, and the Connor-Davidson Resilience Scale. Cross-lagged models were used to analyze the relationships between sleep and resilience. RESULTS Both daytime dysfunction and sleep disturbance had an independent bi-directional relationship with resilience. Higher resilience scores predicted overall better sleep quality and shorter sleep latency, but not vice versa. Sleep disturbance and daytime dysfunction had stronger effects on resilience. CONCLUSIONS These findings highlight the importance of future school interventions for sleep to improve students' resilience.
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Liu BP, Wang XT, Liu ZZ, Wang ZY, An D, Wei YX, Jia CX, Liu X. Depressive symptoms are associated with short and long sleep duration: A longitudinal study of Chinese adolescents. J Affect Disord 2020; 263:267-273. [PMID: 31818788 DOI: 10.1016/j.jad.2019.11.113] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 11/21/2019] [Accepted: 11/26/2019] [Indexed: 01/16/2023]
Abstract
AIMS Sleep loss and irregular sleep patterns in adolescents are major public health concerns in the modern society. This study aimed to explore the associations between short and long sleep duration and depressive symptoms among Chinese adolescents. METHODS A total of 7311 adolescents who participated in the baseline survey and were followed up 1 year or 2 years later were included in the analyses. Participants completed a self-administered questionnaire at baseline and follow-up surveys. The Center for Epidemiologic Studies Depression (CES-D) scale was used to assess depressive symptoms. Generalized estimating equation (GEE) and restrictive cubic spline models were used to estimate the association between sleep duration and depressive symptoms. RESULTS After adjusting for adolescent and family covariates, sleep duration <8 h and >=9 h on weekdays and sleep duration <8 h and >=12 h on weekends were significantly associated with depressive symptoms compared with sleep 8 h. Weekend-weekday sleep difference >=3 h or <-1 h (ie. sleeping >1 h on weekdays than weekends) was also associated with depressive symptoms. There were U-shaped relationships between sleep duration on weekdays, weekends, or weekday-weekend sleep difference and depressive symptoms. LIMITATIONS Sleep duration and depression were measured by self-report. CONCLUSIONS Our findings highlight the risk of short and long sleep duration, and weekday-weekend sleep imbalance for depression in adolescents.
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Affiliation(s)
- Bao-Peng Liu
- Department of Epidemiology, Shandong University School of Public Health, Jinan, China; Shandong University Center for Suicide Prevention and Research, Jinan, China
| | - Xin-Ting Wang
- Department of Epidemiology, Shandong University School of Public Health, Jinan, China; Shandong University Center for Suicide Prevention and Research, Jinan, China
| | - Zhen-Zhen Liu
- Department of Epidemiology, Shandong University School of Public Health, Jinan, China; Shandong University Center for Suicide Prevention and Research, Jinan, China
| | - Ze-Ying Wang
- Department of Epidemiology, Shandong University School of Public Health, Jinan, China; Shandong University Center for Suicide Prevention and Research, Jinan, China
| | - Di An
- Department of Epidemiology, Shandong University School of Public Health, Jinan, China; Shandong University Center for Suicide Prevention and Research, Jinan, China
| | - Yan-Xin Wei
- Department of Epidemiology, Shandong University School of Public Health, Jinan, China; Shandong University Center for Suicide Prevention and Research, Jinan, China
| | - Cun-Xian Jia
- Department of Epidemiology, Shandong University School of Public Health, Jinan, China; Shandong University Center for Suicide Prevention and Research, Jinan, China.
| | - Xianchen Liu
- Department of Epidemiology, Shandong University School of Public Health, Jinan, China; School of Psychology, South China Normal University, Shipai, Guangzhou, China; Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA.
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42
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Liu X, Liu ZZ, Liu BP, Sun SH, Jia CX. Associations between sleep problems and ADHD symptoms among adolescents: findings from the Shandong Adolescent Behavior and Health Cohort (SABHC). Sleep 2019; 43:5650389. [DOI: 10.1093/sleep/zsz294] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 11/17/2019] [Indexed: 12/11/2022] Open
Abstract
Abstract
Study Objectives
Sleep problems and symptoms of attention-deficit hyperactivity disorder (ADHD) in adolescence are common. Little is known about the prospective the prospective associations between sleep and subsequent ADHD symptoms in adolescents. This study examined the prospective associations between sleep problems and subsequent ADHD symptoms in a large sample of adolescents.
Methods
Participants included 7072 adolescents from the Shandong Adolescent Behavior and Health Cohort (SABHC) study in Shandong, China. Participants were initially assessed in November–December of 2015 and were reassessed 1-year later in 2016. Sleep duration, sleep problems, and psychosocial information were collected using a structured questionnaire. ADHD symptoms were measured by the Achenbach Child Behavior Checklist-Youth Self-Report.
Results
At baseline, 7.6% participants had clinically relevant ADHD symptoms, which were highly comorbid with sleep problems including insomnia symptoms, poor sleep quality, symptoms of restless legs syndrome (RLS), frequent snoring, and short sleep duration. Of the 6531 participants without clinically relevant ADHD symptoms at baseline, 4.5% reported clinically relevant ADHD symptoms at 1-year follow-up. After adolescent and family covariates were adjusted for, insomnia (OR = 2.09, 95% CI = 1.45–3.02), RLS (OR = 1.47, 95% CI = 1.02–2.11), and frequent snoring (OR = 2.30, 95% CI = 1.36–3.90) were all significantly associated with subsequent ADHD symptoms.
Conclusion
ADHD symptoms and sleep problems are highly comorbid. Insomnia, RLS and frequent snoring appear to be significant predictors of subsequent ADHD symptoms. Our study highlights the importance of assessing and managing sleep problems for prevention and clinical treatment of ADHD symptoms in adolescence.
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Affiliation(s)
- Xianchen Liu
- School of Public Health, Shandong University, Jinan, China
- South China Normal University School of Psychology, Guangzhou, China
- University of Tennessee Health Science Center, Memphis
| | - Zhen-Zhen Liu
- School of Public Health, Shandong University, Jinan, China
| | - Bao-Peng Liu
- School of Public Health, Shandong University, Jinan, China
| | - Shi-Hua Sun
- Karolinska Institutet Psychiatry, Stockholm, Sweden
| | - Cun-Xian Jia
- School of Public Health, Shandong University, Jinan, China
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Goldstein TR, Franzen PL. Sleep difficulties and suicidality in youth: current research and future directions. Curr Opin Psychol 2019; 34:27-31. [PMID: 31539832 DOI: 10.1016/j.copsyc.2019.08.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 08/12/2019] [Accepted: 08/16/2019] [Indexed: 01/05/2023]
Abstract
Studies have established a clear relationship between subjective sleep problems and the continuum of suicidality in adolescents. These studies are primarily cross-sectional in nature and conducted with epidemiological and depressed clinical samples. More recent studies focus on prospective data. Herein, we provide an update on current studies on the sleep-suicide association among youth. To further the critical mission of youth suicide prevention, future directions include more nuanced study of sleep employing a sleep health framework, longitudinal studies employing both objective and subjective sleep measures, fine-grained temporal associations between these constructs and their fluctuations over time, as well as enhanced understanding of the mechanisms underlying these associations.
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Affiliation(s)
- Tina R Goldstein
- Western Psychiatric Hospital, University of Pittsburgh School of Medicine, United States.
| | - Peter L Franzen
- Western Psychiatric Hospital, University of Pittsburgh School of Medicine, United States.
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Fekih‐Romdhane F, Jendoubi J, Saguem BN, Ridha R, Cheour M. The link between sleep disturbances and suicidal thoughts and behaviors in remitted bipolar I patients. J Clin Psychol 2019; 75:1643-1657. [DOI: 10.1002/jclp.22793] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 03/20/2019] [Accepted: 04/01/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Feten Fekih‐Romdhane
- Faculty of Medicine of TunisTunis El Manar University Tunisia
- Psychiatry Department "E"Razi HospitalMannouba Tunisia
| | - Jihen Jendoubi
- Faculty of Medicine of TunisTunis El Manar University Tunisia
- Psychiatry Department "E"Razi HospitalMannouba Tunisia
| | - Bochra Nourhène Saguem
- Faculty of Medicine of TunisTunis El Manar University Tunisia
- Psychiatry Department "E"Razi HospitalMannouba Tunisia
| | - Rym Ridha
- Faculty of Medicine of TunisTunis El Manar University Tunisia
- Psychiatry Department "E"Razi HospitalMannouba Tunisia
| | - Majda Cheour
- Faculty of Medicine of TunisTunis El Manar University Tunisia
- Psychiatry Department "E"Razi HospitalMannouba Tunisia
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