Sleep Apnea Increases Suicide Risk

Sleep disturbance contributes to suicide risk beyond its association with frequently co-occurring risk factors, such as depression, said Todd Bishop, Ph.D., a health science specialist at the Veterans Affairs (VA) Center of Excellence for Suicide Prevention in Canandaigua, New York, and a senior instructor in psychiatry at the University of Rochester Medical Center. He and colleagues explored an association between sleep apnea and suicidal thoughts and behavior.

Although sleep apnea affects an estimated 3 to 7 percent of men and 2 to 5 percent of women, its impact on mental health has received little research attention, Bishop said. Sleep apnea fragments the sleep cycle and lowers sleep quality, he said, increasing impulsivity and decreasing executive functioning, potentially reducing an individual’s ability to cope with stressors.

His group analyzed data from the 2014 National Survey on Drug Use and Health (NSDUH). After excluding participants under age 18 or with incomplete data, Bishop’s team assessed findings from 41,075 respondents.

Nearly three percent of their sample–1,179 individuals–reported having been diagnosed with sleep apnea, fewer than expected, Bishop said, perhaps because sleep apnea is underdiagnosed. Of those reporting sleep apnea, nearly 10 percent said they had thought seriously about suicide in the past 12 months, compared with about 5 percent of those without sleep apnea. People with sleep apnea also reported having planned suicide or attempted it more often than those without sleep apnea.

A diagnosis of sleep apnea or any other sleep disorder, Bishop said, presents an early opportunity for health care providers to initiate conversations with patients about suicide and mental health. ■