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Thapa S, Yadav DK. Role of sleep problem on suicidal behaviour and non-suicidal self-injury among adolescents in Pokhara, Nepal. PLoS One 2024; 19:e0305221. [PMID: 39321162 PMCID: PMC11423960 DOI: 10.1371/journal.pone.0305221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 05/25/2024] [Indexed: 09/27/2024] Open
Abstract
INTRODUCTION Sleep is a fundamental human requirement, considered one of the major contributing factors to physical and mental health, especially among adolescents. Poor quality sleep has many potential consequences including non-suicidal self-injury (NSSI), suicidal thoughts or behaviour and complete suicide. The NSSI and suicidal behaviour are increasing in Nepal. Thus, this study aimed to assess the role of sleep problem on suicidal behaviour and non-suicidal self-injury among adolescents in Pokhara metropolitan, Nepal. METHODS A cross-sectional analytical study was conducted among 673 adolescents using a multistage cluster sampling technique from private and public schools in Pokhara Metropolitan. Self-administered questionnaire was used for data collection. Collected data was entered and managed in EpiData (version 3.1) and analysed in IBM SPSS (version 23). Binary logistic regression was used to identify the association of sleep problem with NSSI and suicidal behaviour. RESULTS The study found that sleep problem (65.2%, 439), suicidal behaviour (18.6%, 125) and NSSI (57.9%, 390) were prevalent among adolescents in study setting. The presence of sleep problem significantly influenced the suicidal behavior (AOR = 3.88, 95% CI = 2.27-6.63) alongside the sex of student (AOR = 1.96, 95% CI = 1.28-3.00), adolescents from family having monthly income less than NPR 40,000 (AOR = 1.97 95% CI = 1.16-3.35) and private schools students (AOR = 2.99, 95% CI = 1.84-4.86). Likewise, sleep problem was also associated with non-suicidal self-injury (AOR = 3.24, 95% CI = 2.26-4.65), in addition to attending private school (AOR = 2.52, 95% CI = 1.71-3.72). CONCLUSION This study concludes that sleep problem is prevalent among the adolescents and increase the risk of NSSI and suicidal behaviour. Therefore, parents and teachers need to assess their conditions and help them maintain sound sleep. Additionally, suicide prevention strategies need to be adopted to mitigate further risk.
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Affiliation(s)
- Seema Thapa
- School of Health and Allied Sciences, Pokhara University, Pokhara, Nepal
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Pajić V, Orešković S. An Exploratory Analysis of Fifteen Years Suicide Trends Using Population-Level Data From Croatian Committed Suicides Registry. Front Public Health 2022; 10:857284. [PMID: 35757608 PMCID: PMC9215280 DOI: 10.3389/fpubh.2022.857284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 05/10/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives The provide a descriptive analysis of the available population-level aggregated data on committed suicides in the Republic of Croatia, in the 2004-2018 period, showing emerging trends in suicide incidence focusing on sex/age/geographical distribution of suicides and the primary and secondary causes of suicide mortality, as well as making comparisons with similar neighboring neighboring countries. Methods The aggregated suicide data were obtained from the Croatian Committed Suicides Registry, a national registry maintained by the public health authority. The raw data extract was organized into tables according to several variables (age, sex, place of birth, place of residence, and cause of death). Simple descriptive statistics were performed on the structured data. Results Despite being among the highest in the world and EU, the number of committed suicides in Croatia is in decline since 2004. A higher number of suicides by males was observed when compared to females. Most of the suicides occur during spring and summer. The wealthier, northern continental region of the country had the highest average rate of committed suicides per 1,00,000 population, contrary to some of the findings in the published literature associating economic instability with suicide. The most common way to commit suicide for both sexes in all age groups is self-harm by hanging, strangulation and suffocation. Suicide by firearm and explosive devices discharge remains higher than the global average. Conclusions Despite its steadily declining incidence rates in the past 20 years, suicides remain a major public health challenge in Croatia. Results may bolster the Ugro-Finnish suicide hypothesis, linking higher suicide rates to regions with populations of Hungarian descent.
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Affiliation(s)
- Vanja Pajić
- Independent Researcher, Zagreb, Croatia.,Department of Medical Sociology and Health Economics, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Stjepan Orešković
- Department of Medical Sociology and Health Economics, School of Medicine, University of Zagreb, Zagreb, Croatia
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Lan Z, Pau K, Md Yusof H, Huang X. The Effect of Emotion Regulation on Non-Suicidal Self-Injury Among Adolescents: The Mediating Roles of Sleep, Exercise, and Social Support. Psychol Res Behav Manag 2022; 15:1451-1463. [PMID: 35698565 PMCID: PMC9188465 DOI: 10.2147/prbm.s363433] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/26/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To explore the relationship between adolescents’ emotion regulation ability and non-suicidal self-injury (NSSI) behavior and the role of sleep, exercise, and social support in this relationship. Methods A total of 2573 adolescents were investigated with the Cognitive Emotion Regulation Scale, the Social Support Scale for Children and Adolescents, the Ottawa Self-Injury Questionnaire, and the Self-Made Living Condition Questionnaire, and path analysis was conducted based on the structural equation model (SEM). Results 1) There was a significant correlation between emotion regulation ability and NSSI behavior; 2) sleep and social support played a mediating role between emotion regulation ability and NSSI behavior; and 3) sleep modulated the direct effect of negative emotion regulation ability on NSSI, while exercise modulated the direct effect of positive emotion regulation ability on NSSI, which indicated that sleep and exercise could effectively alleviate NSSI behavior caused by the lack of emotion regulation in adolescents.
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Affiliation(s)
- Zhensong Lan
- School of Public Administrations, Hechi University, Hechi, Guangxi, 546300, People’s Republic of China
- National Child Development Research Centre, Sultan Idris Education University, Tanjong Malim Perak, 35900, Malaysia
| | - Kee Pau
- Department of Psychology and Counseling, Faculty of Human Development, Sultan Idris Education University, Tanjong Malim Perak, 35900, Malaysia
- Correspondence: Kee Pau, Director of Counseling Center, Bangunan Bitarasiswa, Tingkat Bawah, Kampus Sultan Abdul Jalil Shah Universiti Pendidikan Sultan Idris, Tanjong Malim Perak, 35900, Malaysia, Tel +60 167228023, Email
| | - Hapsah Md Yusof
- Department of Psychology and Counseling, Faculty of Human Development, Sultan Idris Education University, Tanjong Malim Perak, 35900, Malaysia
| | - Xuefang Huang
- College of Humanities & Social Sciences, Huazhong Agricultural University, Wuhan, Hubei, 430070, People’s Republic of China
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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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Safa F, Chaiton M, Mahmud I, Ahmed S, Chu A. The association between exposure to second-hand smoke and sleep disturbances: A systematic review and meta-analysis. Sleep Health 2020; 6:702-714. [PMID: 32446663 DOI: 10.1016/j.sleh.2020.03.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 03/20/2020] [Accepted: 03/22/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the association between second-hand smoke (SHS) exposure and sleep disturbances by systematically reviewing the literature base and to quantify this association by conducting a meta-analysis. METHOD We did a systematic search of five databases- PubMed, Embase, CINAHL Plus, Web of Science - Core Collection, and Google Scholar. The primary outcomes were short sleep duration (SSD), poor sleep quality (PSQ), and excessive daytime sleepiness (EDS). RESULT Our systematic search yielded a total of 1623 studies. However, 12 studies qualified for qualitative synthesis and 11 studies (12 surveys) with adequate information were included in the meta-analysis involving 730,808 participants. All the studies were cross-sectional. We found an association between SHS exposure and SSD [pooled OR: 1.20 (95% CI, 1.09-1.33; p = 0.0003; I2= 68%), N = 7]; EDS [pooled OR: 1.07 (95% CI, 1.01-1.13; p = 0.02; I2 = 0%), N = 4]; and PSQ [pooled OR: 1.12 (95% CI, 1.01-1.23; p = 0.03; I2 = 79%), N = 10]. Subgroup analyses suggest significant association between SHS exposure and PSQ among adolescents. However, no such association was observed among adults. In addition, no significant association was observed between PSQ and SHS exposure when biomarker was used to identify SHS exposure. CONCLUSION This study is the first systematic review and meta-analysis to examine the association between SHS exposure and sleep outcomes. Self-reported exposure to SHS is positively associated with SSD, EDS, and PSQ, although the effects are modest. Further studies with robust methodology to ascertain exposure information are warranted to further elucidate the relationship between SHS exposure and sleep disturbances.
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Affiliation(s)
- Farhana Safa
- Department of Public Health, Dalla Lana School of Public Health, University of Toronto, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, Canada.
| | - Michael Chaiton
- Department of Public Health, Dalla Lana School of Public Health, University of Toronto, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, Canada; Ontario Tobacco Research Unit (OTRU), Toronto, Canada
| | - Ilias Mahmud
- Department of Public Health, College of Public Health and Health Informatics, Qassim University, Bukayriah, Saudi Arabia
| | - Shamim Ahmed
- Department of Public Health, Dalla Lana School of Public Health, University of Toronto, Canada
| | - Alanna Chu
- Department of Public Health, Dalla Lana School of Public Health, University of Toronto, Canada; Ontario Tobacco Research Unit (OTRU), Toronto, Canada
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Abstract
Objective/Background: Poor sleep has been shown to have multiple negative outcomes during adolescence, in both academic and mental health domains. Several studies have identified the association between poor sleep and suicide risk in adolescents. However, onset of and engagement in nonsuicidal self-injury (NSSI) is also common in this age group, but this behavior has rarely been studied in association with sleep in adolescent samples. In the current study, it was expected that poorer sleep and more symptoms of insomnia would associate with a greater likelihood of recent NSSI engagement and greater NSSI severity. Participants: Data were collected from 387 community adolescents (mean age = 14.19, SD = 1.08), 9% of whom reported NSSI in the past 6 months. The gender breakdown was about even (52% female) and the majority of the sample was White (88.5%). Methods: Adolescent participants were recruited from middle and high schools for a study on mental health and risk behaviors. Researchers visited schools and administered self-report questionnaires to students in large groups. Measures assessed NSSI engagement and severity features, overall sleep quality, and insomnia symptoms. Results: Results indicated that greater insomnia symptoms, but not overall sleep quality, were significantly associated with greater likelihood of recent NSSI engagement. Sleep variables were not significantly associated with NSSI severity among adolescents with recent NSSI. Conclusions: Insomnia symptoms seem to be associated with recent engagement in NSSI. Adolescents who report symptoms of insomnia should also be assessed for self-harm behavior.
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Affiliation(s)
- Shelby L. Bandel
- Graduate Student in the Department of Psychological Sciences, Western Kentucky University, 1906 College Heights Blvd., Bowling Green, KY, 42101,
| | - Amy M. Brausch
- Associate Professor in the Department of Psychological Sciences at Western Kentucky University. To whom correspondences should be addressed at: Western Kentucky University, Department of Psychological Sciences, 1906 College Heights Blvd., Bowling Green, KY, 42101, , 270-745-4407 (office), 270-745-3475 (fax)
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Meir P, Alfano CA, Lau S, Hill RM, Palmer CA. Sleep Patterns and Anxiety in Children Interact to Predict Later Suicidal Ideation. CHILDRENS HEALTH CARE 2019; 48:372-393. [PMID: 32675893 PMCID: PMC7365578 DOI: 10.1080/02739615.2019.1630283] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Elevated levels of childhood anxiety pose risk for suicide; however, factors that accentuate this risk are unknown. Seventy-one children participated in a longitudinal study investigating anxiety and sleep in childhood (between 7-11 years) and later suicidal ideation (SI; M = 3.3 years later). Sleep was assessed via subjective reports and objective measures (actigraphy and polysomnography). Children with greater anxiety symptoms were at greater risk for later SI when sleep disturbances were present in childhood. Results suggest that sleep disruption may amplify SI risk in anxious children.
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Affiliation(s)
- Priel Meir
- Department of Psychology, University of Houston, Houston, TX 77004
| | | | - Simon Lau
- Department of Psychology, University of Houston, Houston, TX 77004
| | - Ryan M. Hill
- Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030
| | - Cara A. Palmer
- Department of Psychology, Montana State University, Bozeman, MT 59717
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Tseng WC, Liang YC, Su MH, Chen YL, Yang HJ, Kuo PH. Sleep apnea may be associated with suicidal ideation in adolescents. Eur Child Adolesc Psychiatry 2019; 28:635-643. [PMID: 30220076 DOI: 10.1007/s00787-018-1227-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 09/08/2018] [Indexed: 12/21/2022]
Abstract
Suicide is a major threat to adolescent health. Sleep problems increase the risk of adolescent suicidal behavior, but the role of sleep-disordered breathing (e.g., sleep apnea) is unclear. We investigated whether sleep apnea had an effect on suicidal ideation that was independent of depression and perceived stress. We examined a series of sleep variables with suicidal ideation in 746 fifth and seventh graders using self-reported questionnaires to assess time in bed, sleep quality, insomnia, and sleep apnea while controlling depression and perceived stress. Overall, 8.8% of students aged 10-14 years reported having recent suicidal ideation, and 33% or 3.8%, depending on the screening criteria, reported having suspected sleep apnea. The sleep variables were all associated with an increased risk of suicidal ideation, but the magnitude of effects was largely attenuated when depression and perceived stress were included in the models. Suspected sleep apnea using daytime sleepiness as a screening criterion was independently associated with suicidal ideation (odds ratio = 2.25, p < 0.05). Suspected sleep apnea was associated with suicidal ideation that was partly independent of depression and stress, which reveals the pertinence of screening for sleep apnea among school students and designing proper prevention strategies for reducing youth suicidal behavior.
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Affiliation(s)
- Wen-Che Tseng
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02215, USA.,National Taiwan University Hospital, 7, Zhongshan S. Rd., Taipei, Taiwan
| | - Yun-Chieh Liang
- Clinical Trial Center, National Taiwan University Hospital, 7, Zhongshan S. Rd., Taipei, Taiwan
| | - Mei-Hsin Su
- Department of Public Health and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, 17, Xuzhou Rd., Taipei, Taiwan
| | - Yun-Ling Chen
- Department of Public Health and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, 17, Xuzhou Rd., Taipei, Taiwan
| | - Hao-Jan Yang
- Department of Public Health, Chung Shan Medical University, 110, sec.1, Jianhuo N. Rd., Taichung, Taiwan
| | - Po-Hsiu Kuo
- Department of Public Health and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, 17, Xuzhou Rd., Taipei, Taiwan. .,Research Center for Genes, Environment and Human Health, National Taiwan University, 2, Xuzhou Rd., Taipei, Taiwan.
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Liu BP, Wang XT, Liu ZZ, Wang ZY, Liu X, Jia CX. Stressful life events, insomnia and suicidality in a large sample of Chinese adolescents. J Affect Disord 2019; 249:404-409. [PMID: 30822663 DOI: 10.1016/j.jad.2019.02.047] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 02/12/2019] [Accepted: 02/17/2019] [Indexed: 12/12/2022]
Abstract
AIMS This study aimed to examine the associations between stressful life events, insomnia, and suicidality including suicidal ideation (SI), suicide plan (SP) and suicide attempt (SA) in a large sample of Chinese adolescents. METHODS A total of 11,831 adolescents who participated in the baseline survey of Shandong Adolescent Behavior and Health Cohort were included for the analysis. Participants were sampled from 8 middle/high schools in 3 counties of Shandong, China. Participants completed a structured behavior and health questionnaire, including suicidality, demographics, depression/anxiety, stressful life events (SLEs), and insomnia in November-December 2015. A series of logistic regression models and mediation analyses were performed to examine the associations between SLEs, insomnia and suicidality. RESULTS The prevalence rates of overall suicidality, SI, SP and SA in the last year were 13.1%, 12.5%, 3.3%, and 1.5%, respectively. SLEs were significantly associated with overall suicidality, SI, and SP. Insomnia was an independent risk factor of suicidality and a mediator of the association between SLEs and suicidality. The total effect of SLEs on overall suicidality was 0.597 (95%CI: 0.534-0.661), including 0.457 (95%CI: 0.391-0.523) for direct effect and 0.158 (95%CI: 0.138-0.178) for indirect effect. Insomnia also mediated the associations of SLEs with SI, SP and SA, respectively. LIMITATIONS Causal relationship could not be concluded because this study is cross-sectional. CONCLUSIONS Stressful life events and insomnia are directly associated with suicidality in adolescents. The association between SLEs and suicidality is partially mediated by insomnia.
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Affiliation(s)
- Bao-Peng Liu
- Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China; Shandong University Center for Suicide Prevention and Research, No.44, Wenhuaxi Rd, Lixia Dist, Jinan 250012, China
| | - Xin-Ting Wang
- Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China; Shandong University Center for Suicide Prevention and Research, No.44, Wenhuaxi Rd, Lixia Dist, Jinan 250012, China
| | - Zhen-Zhen Liu
- Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China; Shandong University Center for Suicide Prevention and Research, No.44, Wenhuaxi Rd, Lixia Dist, Jinan 250012, China
| | - Ze-Ying Wang
- Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China; Shandong University Center for Suicide Prevention and Research, No.44, Wenhuaxi Rd, Lixia Dist, Jinan 250012, China
| | - Xianchen Liu
- Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China; Shandong University Center for Suicide Prevention and Research, No.44, Wenhuaxi Rd, Lixia Dist, Jinan 250012, China; School of Psychology, South China Normal University, Shipai, Guangzhou 510631, China; The University of Tennessee Health Science Center, Memphis, TN 38163, USA.
| | - Cun-Xian Jia
- Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China; Shandong University Center for Suicide Prevention and Research, No.44, Wenhuaxi Rd, Lixia Dist, Jinan 250012, China.
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Liu JW, Tu YK, Lai YF, Lee HC, Tsai PS, Chen TJ, Huang HC, Chen YT, Chiu HY. Associations between sleep disturbances and suicidal ideation, plans, and attempts in adolescents: a systematic review and meta-analysis. Sleep 2019; 42:5370501. [DOI: 10.1093/sleep/zsz054] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 01/27/2019] [Indexed: 02/06/2023] Open
Affiliation(s)
- Jen-Wei Liu
- Department of Pharmacy, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Department of Pharmacy, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Yu-Kang Tu
- Department of Public Health, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Ying-Fan Lai
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
| | - Hsin-Chien Lee
- Department of Psychiatry, Taipei Medical University Shuang Ho Hospital, New Taipei City, Taiwan
- Research Center of Sleep Medicine, School of Medicine, Taipei Medical University, Taipei City, Taiwan
| | - Pei-Shan Tsai
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
| | - Ting-Jhen Chen
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
| | - Hui-Chuan Huang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
| | - Yu-Ting Chen
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
- Department of Psychiatry, Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan
| | - Hsiao-Yean Chiu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
- Research Center of Sleep Medicine, School of Medicine, Taipei Medical University, Taipei City, Taiwan
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Hyun MK, Baek Y, Lee S. Association between digestive symptoms and sleep disturbance: a cross-sectional community-based study. BMC Gastroenterol 2019; 19:34. [PMID: 30782128 PMCID: PMC6381712 DOI: 10.1186/s12876-019-0945-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 01/29/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND This study was conducted to analyze the association between digestive symptoms and sleep disturbance, and to determine if any digestive symptoms are related to sleep disturbance. METHODS This was a cross-sectional study of 5792 subjects surveyed in a community-based cohort. Subjects provided information regarding the quality of sleep as assessed by the Pittsburgh Sleep Quality Index (PSQI), as well as digestive symptoms as assessed by the Gastrointestinal Symptom Rating Scale (GSRS). Logistic regressions were used to examine factors associated with sleep quality. RESULTS The mean PSQI global score of the no sleep disturbances group (n = 4948) was 3.92 (SD = 2.14), while that of the sleep disturbance group (n = 844) was 11.18 (SD = 2.17). The association between digestive symptoms and sleep disturbance was evaluated by logistic regression after adjusting for cofounding factors. The results revealed that sleep disturbances were associated with digestive symptoms (aOR = 1.29, 95% CI = 1.22-1.36), especially abdominal pains (aOR = 1.63, 95% CI = 1.19-2.25), acid regurgitation (aOR = 1.48, 95% CI = 1.17-1.86), abdominal distension (aOR = 1.80, 95% CI = 1.42-2.28), and eructation (aOR = 1.59, 95% CI = 1.24-2.03). CONCLUSIONS Digestive symptoms and sleep disturbances seem to be associated. These results will help medical professionals to effectively diagnose and manage patients with sleep disturbance. Furthermore, subsequent studies using comprehensive longitudinal data should be conducted to confirm the results of the present study.
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Affiliation(s)
- Min Kyung Hyun
- Department of Preventive Medicine, College of Korean Medicine, Dongguk University, Gyeongju, 38066, Republic of Korea
| | - Younghwa Baek
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, 1672, Republic of Korea
| | - Siwoo Lee
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, 1672, Republic of Korea.
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Shulman S, Scharf M. Adolescent psychopathology in Times of Change: The need for integrating a developmental psychopathology perspective. J Adolesc 2018; 65:95-100. [PMID: 29567491 DOI: 10.1016/j.adolescence.2018.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In addition to the major physical, sexual and cognitive changes, as well as changes in relationships with parents and peers, in recent years adolescents also have to cope with many technological changes and increasing societal instabilities. Most of the existing research has examined the extent to which increasing uncertainties might impact expression of psychopathology and its magnitude. Emerging from a developmental psychopathology perspective, we are looking first for a better understanding of the meaning that adolescents give to these changes, which in turn is likely to affect their behavior. We are also looking for better understanding the importance of the role parents, and other societal systems/institutions (such as peers) play in ameliorating or enhancing the likelihood of maladaptive adolescent behavior under these circumstances.
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Assessment and Treatment of Pediatric Sleep Problems: Knowledge, Skills, Attitudes and Practices in a Group of Community Child Psychiatrists. Med Sci (Basel) 2018; 6:medsci6010018. [PMID: 29473880 PMCID: PMC5872175 DOI: 10.3390/medsci6010018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 02/19/2018] [Accepted: 02/20/2018] [Indexed: 11/17/2022] Open
Abstract
As part of a university-based quality improvement project, we aimed to evaluate child psychiatrists’ knowledge, skills, attitudes, and practices regarding assessment and treatment of pediatric sleep problems. We developed a nine-question survey of knowledge, skills, attitudes, and practices regarding assessing for and treating sleep complaints in pediatric patients, and administered this survey to child psychiatrists in training and in practice in the state of Missouri. Respondents reported sleep hygiene as the first-line treatment strategy, followed by the use of supplements or over-the-counter remedies. The most common barriers to evidence-based assessment and treatment of sleep problems were the lack of ability to obtain reliable history, and parental preference for medications over behavioral approaches for sleep concerns. These results suggest potential opportunities for enhancing knowledge regarding validated assessment tools and non-pharmacological treatment options for sleep problems. Additional research is needed to further assess the quality and type of sleep education provided in child psychiatry training programs.
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Abstract
Sleep disturbances are common in pediatric psychiatric disorders and constitute key elements in diagnostic symptomatology of various primary psychiatric disorders including bipolar disorder, depression, and anxiety disorder. Although sleep is not included in key defining criteria of some impairing illnesses such as obsessive-compulsive disorder and schizophrenia, these disorders present with a very high prevalence of sleep disturbances. The interaction between sleep and psychopathology is very complex with significant interrelationship in development, severity, and prognosis of psychiatric disorders and comorbid sleep disturbances. The research ranging from small intervention case series to large epidemiologic studies have demonstrated the role of specific sleep complaints in specific psychiatric diagnoses. However, the research using objective instruments such as polysomnography and actigraphy remains limited in youth with psychiatric disorders. The intervention studies using pharmaceutical treatment specifically focusing on sleep disturbances in psychiatric disorders are also sparse in the pediatric literature. Early identification of sleep disturbances and behavioral management using cognitive behavior therapy-based tools appear to be the most effective approach for treatment. The use of psychotropic medications such as selective serotonin reuptake inhibitors for the treatment of primary psychiatric disorder often alleviate the psychological barriers for sleep but may lead to emergence of other sleep issues such as restless leg syndrome. The safety and efficacy data of hypnotics for primary sleep disorders are limited in pediatrics and should be avoided or used with extreme caution in children with comorbid sleep and psychiatric problems.
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Affiliation(s)
- Ujjwal Ramtekkar
- Department of Psychiatry, Mercy Children׳s Hospital, St Louis, MO.
| | - Anna Ivanenko
- Department of Psychiatry, Northwestern University, Chicago, IL
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15
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Lin FG, Lin JD, Hsieh YH, Chang CY. Quarrelsome family environment as an enhanced factor on child suicidal ideation. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:3245-53. [PMID: 25178707 DOI: 10.1016/j.ridd.2014.08.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 08/04/2014] [Accepted: 08/04/2014] [Indexed: 05/17/2023]
Abstract
Suicide is a leading cause of death in adolescents, and develops through a process leading from depression to suicidal ideation and self-injury. In this study, we analyzed and compared suicidal ideation among elementary school children from distinct families and school-related backgrounds. We conducted a cross-sectional study to investigate suicidal ideation in elementary school children in Miaoli County of Western Taiwan. Our study included 979 eligible participants and collected data, including suicidal ideation, depression scores, demographic characteristics, and family and school variables. The results revealed that 175 students (17.9%) exhibited depression, and 146 students (14.9%) had contemplated suicide. A quarrelsome family environment was found to be an important independent factor in child suicidal ideation after controlling for depression status. Children living in quarrelsome families showed a 3.7-fold risk of suicidal ideation compared with children in a harmonious family. Among boys living in quarrelsome family environments, suicidal ideation risk was 7.4-fold higher than for girls living in harmonious families. A 27-fold high increased suicidal ideation risk was also observed among the depressed children who living in the quarrelsome family environment, compared with the non-depressed in the harmonious family environment. This study provides novel evidence indicating the enhanced effects of a quarrelsome family environment combined with depression symptoms and among boys on suicidal ideation. These findings suggest of quarrels in a family environment playing an important role on elementary school children's psychological development, and may help parents in improving their mental health.
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Affiliation(s)
- Fu-Gong Lin
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC.
| | - Jing-Ding Lin
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Yu-Hsin Hsieh
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Chien-Yi Chang
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC
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16
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Sleep in infancy and childhood: implications for emotional and behavioral difficulties in adolescence and beyond. Curr Opin Psychiatry 2014; 27:453-9. [PMID: 25247458 DOI: 10.1097/yco.0000000000000109] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW Extensive scientific efforts have been made in an attempt to identify early markers of behavioral and emotional problems. In this context, sleep has received considerable research attention, as it appears to be closely linked to developmental psychopathology. The present review synthesizes some of the most recent findings regarding the concurrent and longitudinal associations between psychopathology and behavioral manifestations of sleep in childhood and adolescence. RECENT FINDINGS Recent evidence suggests that compromised sleep is associated with both internalizing and externalizing problems in childhood and adolescence. Moreover, sleep problems have been shown to predict the development of various emotional and behavioral problems, including depression, anxiety, attention-deficit hyperactivity disorder, risk-taking and aggression. Yet, inconsistencies are apparent, particularly among findings that are based on objective sleep measurement. SUMMARY Taken together, most recent findings suggest that poor sleep in childhood and adolescence constitutes a risk factor for psychopathological symptoms. Accordingly, the importance of early detection and intervention should be a primary goal in clinical settings. In the research domain, the underlying mechanism of these associations should receive future research attention, in an attempt to broaden the understanding of the relationship between sleep and psychopathology.
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