People who are diagnosed with sleep apnea may have an increased risk of dying by suicide, a study in the Journal of Psychiatric Research has found. Sleep apnea is a potentially serious disorder in which breathing repeatedly stops and starts during sleep.
Che-Sheng Chu, M.D., of Kaohsiung Veterans General Hospital in Kaohsiung City, Taiwan, and colleagues examined data from the Taiwan National Health Insurance Research Database. The researchers selected 7,095 adults aged 20 years or older who had been diagnosed with sleep apnea between 1998 and 2010 and 28,380 adults without sleep apnea who were matched based on their age, sex, and comorbidities (such as depressive disorder, diabetes, and/or substance use disorders). They then examined suicide attempts that took place during the follow-up period, which ended December 31, 2011 (all participants were followed up to at least one year after receiving a diagnosis).
Adults with sleep apnea had 4.53 times the risk of carrying out a suicide attempt during the follow-up period compared with those who did not have sleep apnea, after the researchers accounted for demographic data, mental disorders, and physical comorbidities. When the researchers excluded adults with mental disorders, patients with sleep apnea had 4.23 times the risk of carrying out a suicide attempt compared with those who did not have sleep apnea.
During the follow-up period, adults who had sleep apnea also had 3.86 times the risk of repeated suicide attempts compared with those who did not have sleep apnea—a risk that remained about the same when the researchers excluded adults with mental disorders.
The researchers noted several potential reasons for the increased risk of suicide attempts among adults with sleep apnea. For example, studies suggest that people with sleep apnea are more prone to cognitive decline, and people with cognitive impairment have a higher risk of attempting suicide, they wrote. Numerous studies also point to the toll that waking up throughout the night can have on mental health.
“[A]wakening at night leads to a high risk of suicide attempts due to increased utilization of substances, reduced social support, feeling[s] of loneliness, and decreased frontal lobe function,” the researchers wrote. “From clinical and public health perspectives, routine and frequent screening for suicidal ideation is important for patients with sleep apnea. Further studies are necessary to elucidate the pathophysiology of sleep apnea and suicidality.”
For related information, see the American Journal of Psychiatry article “The Evolving Nexus of Sleep and Depression.”
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