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Association of hospital-diagnosed sleep disorders with suicide: a nationwide cohort study

Published online by Cambridge University Press:  01 September 2022

N. Høier ,
T. Madsen ,
A. Spira ,
K. Hawton ,
M. Benros ,
M. Nordentoft  and
A. Erlangsen
N. Høier*
Affiliation:
Mental Health Centre Copenhagen (CORE), Danish Research Institute For Suicide Prevention, Hellerup, Denmark
T. Madsen
Affiliation:
Mental Health Center Copenhagen, Core-copenhagen Research Center For Mental Health, Hellerup, Denmark
A. Spira
Affiliation:
Johns Hopkins Bloomberg School of Public Health, Department Of Mental Health, Baltimore, United States of America
K. Hawton
Affiliation:
University of Oxford, Centre For Suicide Research, Oxford, United Kingdom
M. Benros
Affiliation:
CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Hellerup, Denmark
M. Nordentoft
Affiliation:
Mental Health Center Copenhagen, Core-copenhagen Research Center For Mental Health, Hellerup, Denmark CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Hellerup, Denmark
A. Erlangsen
Affiliation:
CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Hellerup, Denmark
*
*Corresponding author.

Abstract

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Introduction

Sleep disorders and psychiatric disease are closely related, and psychiatric diseases are associated with elevated suicide risks. Yet, the association between sleep disorders and suicide remains to be assessed using a consistent measure of sleep disorders.

Objectives

The aim of this study was to examine whether people with a hospital-diagnosis of sleep disorders had higher suicide rates than people with no diagnosis.

Methods

In a cohort study, nationwide data on all persons aged 15+ years living in Denmark during 1980-2016 were analysed. Sleep disorders were identified through diagnoses recorded during contacts to somatic hospitals. Incidence Rate Ratios (IRR) were estimated using Poisson regression models and adjusted for relevant covariates.

Results

In all, 3,674,563 males and 3,688,164 females were included, of whom 82,223 (2.2%, mean age: 50.2, SD: 17.5) males and 40,003 (1.1%, mean age: 50.6, SD: 19.9) females had sleep disorder diagnoses. Compared to those with no sleep disorders, the adjusted IRRs for suicide were 1.6 (95% CI, 1.4-1.7) and 2.2 (95% CI, 1.8-2.6) for males and females with sleep disorders, respectively. Excess rates for narcolepsy were found for males (IRR:1.2, 95% CI, 1.0-1.5) and females (IRR:3.3, 95% CI, 3.0-4.1), and for sleep apnea in males (IRR:1.8, 95% CI, 1.5-2.2). Males and females had IRRs of 4.1 (95% CI, 3.1-5.5) and 7.0 (95% CI, 4.8-10.1), respectively, 6 months after being diagnosed with a sleep disorder.

Conclusions

Sleep disorders were associated with higher suicide rates even after adjusting for pre-existing mental disorders. Our findings suggest attention towards suicidal ideation in patients suffering from sleep disorders is warranted.

Disclosure

Disclosures and Acknowledgements: Adam Spira has received honoraria for serving as a consultant to Merck and from Springer Nature Switzerland AG for guest editing special issues of Current Sleep Medicine Reports. The other authors report no conflict of in

Keywords

Suicidesuicide preventionSuicidologysleep disorder
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S123 - S124
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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