TY - JOUR
T1 - Association of sleep characteristics with suicidal ideation and suicide attempt among adults aged 50 and older with depressive symptoms in low- and middle-income countries
AU - Owusu, J. T.
AU - Doty, S. B.
AU - Adjaye-Gbewonyo, D.
AU - Bass, J. K.
AU - Wilcox, H. C.
AU - Gallo, J. J.
AU - Spira, A. P.
N1 - Publisher Copyright:
© 2019 National Sleep Foundation
PY - 2020/2
Y1 - 2020/2
N2 - Objectives: Investigate the association of sleep characteristics with suicidal ideation and suicide attempt among middle-aged and older adults with depressive symptoms in five low- and middle-income countries (LMICs). Design: Cross-sectional. Setting: China, Ghana, India, Russia, and South Africa. Participants: Adults aged ≥50 years with depressive symptoms from the World Health Organization (WHO) Study on Global AGEing and Adult Health (n=2,040). Measurements: Predictors were self-reported average sleep duration for the past 2 nights (<7 hours (shorter), 7 to <9 hours (reference), ≥9 hours (longer)), sleep quality for the past 2 nights (moderate/good/very good [both nights], poor/very poor [≥1 night]), past-month insomnia symptoms (none/mild, moderate, severe/extreme), and past-day daytime sleepiness. Outcomes were past-year suicidal ideation and suicide attempt. Analyses were adjusted for age, sex, household wealth, marital status, self-rated health, cognitive performance, number of depressive symptoms, and country of residence. Results: Participants with poor/very poor sleep quality ≥1 night had greater odds of suicidal ideation (vs. moderate/good/very good sleep quality both nights). Participants with moderate and severe/extreme insomnia symptoms had greater odds of suicidal ideation and suicide attempt (vs. none/mild insomnia symptoms). In moderation analyses, greater insomnia symptoms were associated with higher odds of suicidal ideation among women only and those aged 60-60 years and ≥80 years only. Conclusions: Among middle-aged and older adults with depressive symptoms in LMICs, sleep characteristics are markers of—and potential contributors to—suicidal ideation and suicide attempt, and there was evidence of moderation by age and sex. Interventions aimed at preventing suicide-related outcomes in these populations should consider the role of sleep.
AB - Objectives: Investigate the association of sleep characteristics with suicidal ideation and suicide attempt among middle-aged and older adults with depressive symptoms in five low- and middle-income countries (LMICs). Design: Cross-sectional. Setting: China, Ghana, India, Russia, and South Africa. Participants: Adults aged ≥50 years with depressive symptoms from the World Health Organization (WHO) Study on Global AGEing and Adult Health (n=2,040). Measurements: Predictors were self-reported average sleep duration for the past 2 nights (<7 hours (shorter), 7 to <9 hours (reference), ≥9 hours (longer)), sleep quality for the past 2 nights (moderate/good/very good [both nights], poor/very poor [≥1 night]), past-month insomnia symptoms (none/mild, moderate, severe/extreme), and past-day daytime sleepiness. Outcomes were past-year suicidal ideation and suicide attempt. Analyses were adjusted for age, sex, household wealth, marital status, self-rated health, cognitive performance, number of depressive symptoms, and country of residence. Results: Participants with poor/very poor sleep quality ≥1 night had greater odds of suicidal ideation (vs. moderate/good/very good sleep quality both nights). Participants with moderate and severe/extreme insomnia symptoms had greater odds of suicidal ideation and suicide attempt (vs. none/mild insomnia symptoms). In moderation analyses, greater insomnia symptoms were associated with higher odds of suicidal ideation among women only and those aged 60-60 years and ≥80 years only. Conclusions: Among middle-aged and older adults with depressive symptoms in LMICs, sleep characteristics are markers of—and potential contributors to—suicidal ideation and suicide attempt, and there was evidence of moderation by age and sex. Interventions aimed at preventing suicide-related outcomes in these populations should consider the role of sleep.
KW - Adults
KW - Depression
KW - Sleep
KW - Suicide
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U2 - 10.1016/j.sleh.2019.08.009
DO - 10.1016/j.sleh.2019.08.009
M3 - Article
C2 - 31757754
AN - SCOPUS:85076518088
SN - 2352-7218
VL - 6
SP - 92
EP - 99
JO - Sleep Health
JF - Sleep Health
IS - 1
ER -