Abstract

Introduction

Nocturnal wakefulness is a unique risk factor for suicidal ideation in clinical as well as community samples. Preliminary data suggest that morning wakefulness may also be a protective factor against such thinking. However, these associations have not been explored in a nationally-representative dataset.

Methods

Data were collected from the 2015-2016 wave of the National Health and Nutrition Examination Survey. Participants reported typical bedtimes and waketimes. From these values, wakefulness during the night (00:00 to 05:59), morning (06:00 to 11:59), afternoon (12:00 to 17:59), and evening (18:00 to 23:59) was determined. Suicidal ideation was assessed by a question about “thoughts that you would be better off dead, or thoughts of hurting yourself in some way.” Ordinal logistic regression estimated the association between the number of hours awake at particular times of day and the frequency of suicidal ideation. Additional analyses adjusted for demographic factors and depressed mood.

Results

Out of 5133 respondents with available data, 125 reported suicidal ideation several days a week, 36 reported suicidal ideation more than half the days, and 29 reported suicidal ideation nearly every day. When controlling for demographics, morning wakefulness was associated with reduced frequency of suicidal ideation (OR: 0.69, 95% CI: [0.59,0.8]). Controlling for depressed mood attenuated, but did not eliminate, this association. Nocturnal wakefulness was not associated with suicidal ideation in this sample.

Conclusion

Using data from a nationally representative sample, morning wakefulness was associated with less frequent suicidal ideation. However, previous findings regarding nocturnal wakefulness were not replicated. The limited number of individuals in the sample endorsing both suicidal ideation and nighttime wakefulness may have insufficient power to detect an association.

Support

Dr. Grandner is supported by R01MD011600.

中文翻译：

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1096年在全国范围内具有代表性的美国样本中，清醒与自杀意念减少有关

摘要

介绍

夜间清醒是临床以及社区样本中自杀意念的独特危险因素。初步数据表明，早晨的清醒也可能是防止这种想法的保护因素。但是，尚未在全国代表性的数据集中探索这些关联。

方法

数据收集自2015-2016年国家健康和营养检查调查浪潮。参与者报告了典型的就寝时间和唤醒时间。根据这些值，您可以在夜间（00:00至05:59），早晨（06:00至11:59），下午（12:00至17:59）和晚上（18:00至23:59）进行清醒）已确定。自杀念头是通过一个关于“您可能会更好地摆脱死者的想法或以某种方式伤害自己的想法”的问题进行评估的。有序逻辑回归估计了一天中特定时间的清醒小时数与自杀意念发生频率之间的关联。根据人口统计学因素和情绪低落对其他分析进行了调整。

结果

在有可用数据的5133位受访者中，有125位一周几日报告有自杀意念，有36位报告了半天以上有自杀意念，有29位几乎每天都有自杀意念。当控制人口统计学时，清晨与自杀意念发生率降低相关（OR：0.69，95％CI：[0.59，0.8]）。对抑郁情绪的控制减弱但并未消除这种关联。夜间清醒与该样本中的自杀意念无关。

结论

使用全国代表性的数据，早晨的清醒与自杀意念的发生率较低相关。但是，以前关于夜间觉醒的发现没有被复制。样本中认可自杀念头和夜间清醒的人数有限，可能不足以检测关联。

支持

R01MD011600支持Grandner博士。