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Association of suicidal ideation with poor sleep quality among Ethiopian adults

  • Psychiatrics • Original Article
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Abstract

Objective

The objective of this study was to examine the extent to which poor sleep quality is associated with suicidal ideation among Ethiopian adults.

Methods

A cross-sectional study was conducted among 1054 adults attending outpatient clinical facilities in Ethiopia. Standardized questionnaires were utilized to collect data on demographics, sleep quality, lifestyle, and depression status. Depression and suicidal ideation were assessed using the Patient Health Questionnaire-9 (PHQ-9), while the Pittsburgh Sleep Quality Index (PSQI) questionnaire was utilized to assess sleep quality. Multivariate logistic regression models were fit to estimate adjusted odds ratio (AOR) and 95 % confidence intervals (95 % CI).

Results

The prevalence of suicidal ideation was 24.3 % while poor sleep quality (PSQI global score of >5 vs. ≤5) was endorsed by 60.2 % of participants. After adjustment for confounders including depression, poor sleep quality was associated with more than 3-fold increased odds of suicidal ideation (AOR = 3.59; 95 % CI 2.34–5.51). When assessed as a continuous variable, each 1-unit increase in the global PSQI score resulted in a 20 % increased odds for suicidal ideation, even after adjusting for depression (AOR = 1.20; 95 % CI 1.14–1.27). Participants with both poor sleep quality and depression had much higher odds (AOR = 23.22, 95 % CI 14.10–38.28) of suicidal ideation as compared with those who had good sleep quality and no depression although inferences from this analysis are limited due to the wide 95 % CI.

Conclusion

Suicidal ideation and poor sleep quality are highly prevalent. Individuals with poor sleep quality have higher odds of suicidal ideation. If confirmed, mental health services need to address sleep disturbances seriously to prevent suicidal episodes.

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References

  1. Bernert RA, Turvey CL, Conwell Y, Joiner TE Jr (2014) Association of poor subjective sleep quality with risk for death by suicide during a 10-year period: a longitudinal, population-based study of late life. JAMA Psychiatry 71(10):1129–1137

    Article  PubMed  PubMed Central  Google Scholar 

  2. Bernert RA, Nadorff MR (2015) Sleep disturbances and suicide risk. Sleep Med Clin 10(1):35–39

    Article  PubMed  Google Scholar 

  3. (WHO) WHO (2015) Preventing suicide: a global imperative: Available at: http://apps.who.int/iris/bitstream/10665/131056/1/9789241564779_eng.pdf?ua=1&ua=1. Accessed on 11/27/2015.

  4. Nock MK, Hwang I, Sampson N, Kessler RC, Angermeyer M, Beautrais A, Borges G, Bromet E, Bruffaerts R, de Girolamo G et al (2009) Cross-national analysis of the associations among mental disorders and suicidal behavior: findings from the WHO World Mental Health Surveys. PLoS Med 6(8):11

    Article  Google Scholar 

  5. Morgan I, Eguia F, Gelaye B, Peterlin BL, Tadesse MG, Lemma S, Berhane Y, Williams MA (2015) Sleep disturbances and quality of life in Sub-Saharan African migraineurs. J Headache Pain 16:18

    Article  PubMed  PubMed Central  Google Scholar 

  6. Gottlieb DJ, Redline S, Nieto FJ, Baldwin CM, Newman AB, Resnick HE, Punjabi NM (2006) Association of usual sleep duration with hypertension: the Sleep Heart Health Study. Sleep 29(8):1009–1014

    Article  PubMed  Google Scholar 

  7. Gildner TE, Liebert MA, Kowal P, Chatterji S, Snodgrass JJ (2014) Associations between sleep duration, sleep quality, and cognitive test performance among older adults from six middle income countries: results from the Study on Global Ageing and Adult Health (SAGE). J Clin Sleep Med 10(6):613–621

    PubMed  PubMed Central  Google Scholar 

  8. Sutter C, Zollig J, Allemand M, Martin M (2012) Sleep quality and cognitive function in healthy old age: the moderating role of subclinical depression. Neuropsychology 26(6):768–775

    Article  PubMed  Google Scholar 

  9. Leblanc MF, Desjardins S, Desgagne A (2015) Sleep problems in anxious and depressive older adults. Psychol Res Behav Manag 8:161–169

    PubMed  PubMed Central  Google Scholar 

  10. Al-Delaimy WK, Manson JE, Willett WC, Stampfer MJ, Hu FB (2002) Snoring as a risk factor for type II diabetes mellitus: a prospective study. Am J Epidemiol 155(5):387–393

    Article  PubMed  Google Scholar 

  11. Lemma S, Patel SV, Tarekegn YA, Tadesse MG, Berhane Y, Gelaye B, Williams MA (2012) The epidemiology of sleep quality, sleep patterns, consumption of caffeinated beverages, and Khat use among Ethiopian college students. Sleep Disord 2012:583510

    Article  PubMed  PubMed Central  Google Scholar 

  12. Goodwin RD, Marusic A (2008) Association between short sleep and suicidal ideation and suicide attempt among adults in the general population. Sleep 31(8):1097–1101

    PubMed  PubMed Central  Google Scholar 

  13. Byrd K, Gelaye B, Tadessea MG, Williams MA, Lemma S, Berhanec Y (2014) Sleep disturbances and common mental disorders in college students. Health Behav Policy Rev 1(3):229–237

    Article  PubMed  PubMed Central  Google Scholar 

  14. Bernert RA, Hom MA, Roberts LW (2014) A review of multidisciplinary clinical practice guidelines in suicide prevention: toward an emerging standard in suicide risk assessment and management, training and practice. Acad Psychiatry 38(5):585–592

    Article  PubMed  PubMed Central  Google Scholar 

  15. Bernert RA, Kim JS, Iwata NG, Perlis ML (2015) Sleep disturbances as an evidence-based suicide risk factor. Curr Psychiatry Rep 17(3):554

    Article  PubMed  Google Scholar 

  16. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ (1989) The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 28(2):193–213

    Article  CAS  PubMed  Google Scholar 

  17. Gelaye B, Lohsoonthorn V, Lertmeharit S, Pensuksan WC, Sanchez SE, Lemma S, Berhane Y, Zhu X, Velez JC, Barbosa C et al (2014) Construct validity and factor structure of the Pittsburgh sleep quality index and Epworth sleepiness scale in a multi-national study of African, South East Asian and South American college students. PLoS One 9(12):e116383

    Article  PubMed  PubMed Central  Google Scholar 

  18. Kroenke K, Spitzer RL, Williams JB (2001) The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 16(9):606–613

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Gelaye B, Williams MA, Lemma S, Deyessa N, Bahretibeb Y, Shibre T, Wondimagegn D, Lemenhe A, Fann JR, Vander Stoep A et al (2013) Validity of the Patient Health Questionnaire-9 for depression screening and diagnosis in East Africa. Psychiatry Res 210(2):653–661

    Article  PubMed  Google Scholar 

  20. Gilbody S, Richards D, Brealey S, Hewitt C (2007) Screening for depression in medical settings with the Patient Health Questionnaire (PHQ): a diagnostic meta-analysis. J Gen Intern Med 22(11):1596–1602

    Article  PubMed  PubMed Central  Google Scholar 

  21. Belew M, Kebede D, Kassaye M, Enquoselassie F (2000) The magnitude of khat use and its association with health, nutrition and socio-economic status. Ethiop Med J 38(1):11–26

    CAS  PubMed  Google Scholar 

  22. Kalix P (1987) Khat: scientific knowledge and policy issues. Br J Addict 82(1):47–53

    Article  CAS  PubMed  Google Scholar 

  23. Hastie T, Tibshirani R (1990) Generalized additive models. Chapman-Hall, London

    Google Scholar 

  24. Agargun MY, Kara H, Solmaz M (1997) Subjective sleep quality and suicidality in patients with major depression. J Psychiatr Res 31(3):377–381

    Article  CAS  PubMed  Google Scholar 

  25. Turvey CL, Conwell Y, Jones MP, Phillips C, Simonsick E, Pearson JL, Wallace R (2002) Risk factors for late-life suicide: a prospective, community-based study. Am J Geriatr Psychiatry 10(4):398–406

    Article  PubMed  Google Scholar 

  26. Lapierre S, Boyer R, Desjardins S, Dube M, Lorrain D, Preville M, Brassard J (2012) Daily hassles, physical illness, and sleep problems in older adults with wishes to die. Int Psychogeriatr 24(2):243–252

    Article  PubMed  Google Scholar 

  27. Pigeon WR, Pinquart M, Conner K (2012) Meta-analysis of sleep disturbance and suicidal thoughts and behaviors. J Clin Psychiatry 73(9):e1160–e1167

    Article  PubMed  Google Scholar 

  28. Jacobs N, Myin-Germeys I, Derom C, Delespaul P, van Os J, Nicolson NA (2007) A momentary assessment study of the relationship between affective and adrenocortical stress responses in daily life. Biol Psychol 74(1):60–66

    Article  CAS  PubMed  Google Scholar 

  29. Mannie ZN, Harmer CJ, Cowen PJ (2007) Increased waking salivary cortisol levels in young people at familial risk of depression. Am J Psychiatry 164(4):617–621

    Article  PubMed  Google Scholar 

  30. Gananca L, Oquendo MA, Tyrka AR, Cisneros-Trujillo S, Mann JJ, Sublette ME (2015) The role of cytokines in the pathophysiology of suicidal behavior. Psychoneuroendocrinology 63:296–310

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgment

The authors wish to thank the staff of Addis Continental Institute of Public Health for their expert technical assistance. The authors would also like to thank Saint Paul Hospital for granting access to conduct the study.

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Corresponding author

Correspondence to Bizu Gelaye.

Ethics declarations

All study participants provided informed consent, and the research protocol was approved by the Institutional Review Boards of Addis Continental Institute of Public Health, Addis Ababa, Ethiopia, and the Human Subjects Division at the University of Washington, Seattle, USA.

Funding

This research was supported by an award from the National Institutes of Health, National Institute of Minority Health and Health Disparities (T37-MD001449). The sponsor had no role in the design or conduct of this research.

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements) or nonfinancial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in the study were in accordance with the 1964 Helsinki Declaration and its later amendments and were approved by the Institutional Review Boards of Addis Continental Institute of Public Health, Addis Ababa, Ethiopia, and the Human Subjects Division at the University of Washington, Seattle, USA.

Informed consent

Written informed consent was obtained from all individual participants included in the study.

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Gelaye, B., Okeiga, J., Ayantoye, I. et al. Association of suicidal ideation with poor sleep quality among Ethiopian adults. Sleep Breath 20, 1319–1326 (2016). https://doi.org/10.1007/s11325-016-1418-9

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  • DOI: https://doi.org/10.1007/s11325-016-1418-9

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