Daily and Cumulative Sleep Duration as Predictors of Suicidal Desire and Intent: An Ecological Momentary Assessment Study

• Published in: The journal of clinical psychiatry Vol. 85; no. 2
• Main Authors: Rogers, Megan L, Bozzay, Melanie L
• Format: Journal Article
• Language: English
• Published: United States 03.06.2024
• Subjects: Adult; Ecological Momentary Assessment; Female; Humans; Intention; Male; Middle Aged; Risk Factors; Self Report; Sleep - physiology; Sleep Duration; Suicidal Ideation; Suicide, Attempted - psychology; Suicide, Attempted - statistics & numerical data; Time Factors; Young Adult
• DOI: 10.4088/JCP.23m15164

Shorter sleep duration has been linked to increased suicidal ideation (SI). However, limited research has examined the relationship between nightly sleep duration and short-term fluctuations in suicide risk, as well as the potential clinical utility of leveraging indices of recent (ie, past 3 days) patterns of sleep duration as a marker of acute suicide risk. This study examined associations between nightly and cumulative sleep duration and suicidal desire and intent utilizing ecological momentary assessment (EMA) in a high risk sample of community-based adults. A sample of 237 community based adults with severe SI provided daily indices of self-reported sleep duration and ratings of suicidal desire and intent 6 times per day for 14 consecutive days of EMA monitoring. Data collection took place between February and May 2019. Between-person nightly sleep duration and cumulative sleep duration were negatively associated with suicidal desire ( s = -3.48 and -4.78) and intent ( s = -1.96 and -2.46). At the within person level, nightly sleep duration was negatively related to suicidal desire ( s = -0.51 and -0.47) and intent. Within person cumulative sleep duration, on the other hand, was unrelated to both suicidal desire and intent ( s = -0.26 and -0.09). Our findings highlight the clinical utility of examining individual differences in sleep duration as a marker for suicide-related outcomes, as well as deviations from one's typical nightly sleep as a potential acute predictor of suicide-related outcomes, in addition to information about recent duration over one or more nights of sleep. Limitations and future directions are discussed.