Association of suicidal ideation with poor sleep quality among Ethiopian adults
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The objective of this study was to examine the extent to which poor sleep quality is associated with suicidal ideation among Ethiopian adults.
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).
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.
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.
KeywordsSleep quality Suicidal ideation Suicide Ethiopia Africa
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.
Compliance with ethical standards
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.
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.
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.
Written informed consent was obtained from all individual participants included in the study.
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