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

J Clin Psychiatry. 2024 Jun 3;85(2):23m15164. doi: 10.4088/JCP.23m15164.

Abstract

Objective: 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.

Methods: 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.

Results: Between-person nightly sleep duration and cumulative sleep duration were negatively associated with suicidal desire (Bs = -3.48 and -4.78) and intent (Bs = -1.96 and -2.46). At the within person level, nightly sleep duration was negatively related to suicidal desire (Bs = -0.51 and -0.47) and intent. Within person cumulative sleep duration, on the other hand, was unrelated to both suicidal desire and intent (Bs = -0.26 and -0.09).

Conclusion: 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.

MeSH terms

  • 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