Increased risk of suicidal ideation and/or self-harm in co-morbid insomnia and obstructive sleep apnea (COMISA)
Background: Obstructive sleep apnea (OSA) and insomnia are both associated with suicidal ideation (SI), but it is not known if co-morbid insomnia and obstructive sleep apnea (COMISA) has a synergistic effect. We aim to study the association of symptoms of insomnia, OSA, and COMISA with self-reported...
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Elsevier
2024-12-01
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| Series: | Sleep Epidemiology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667343624000167 |
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| author | Saurabh Kalra Nandakumar Nagaraja Deepak Kalra |
| author_facet | Saurabh Kalra Nandakumar Nagaraja Deepak Kalra |
| author_sort | Saurabh Kalra |
| collection | DOAJ |
| description | Background: Obstructive sleep apnea (OSA) and insomnia are both associated with suicidal ideation (SI), but it is not known if co-morbid insomnia and obstructive sleep apnea (COMISA) has a synergistic effect. We aim to study the association of symptoms of insomnia, OSA, and COMISA with self-reported risk of SI and/or self-harm. Methods: Using cross-sectional data from the National Health and Nutrition Examination Survey (2005–2008) (n = 5,834), we examined the odds of self-reported risk of SI and/or self-harm (past 12-months) with insomnia symptoms, high-risk for OSA, and probable COMISA groups. Insomnia symptoms were identified as having trouble attaining sleep, awakening in between sleep, early awakening on more than 15 nights/month, or diagnosed by physician. High-risk for OSA was assessed by commonly used STOP-Bang questionnaire. Probable COMISA was identified if respondents had both insomnia symptoms and high-risk for OSA. Multiple logistic regression analyses examined the associations, both unadjusted and adjusted for demographics, health behaviors, and depressive symptoms. Results: Self-reported risk of SI and/or self-harm was likely to be more common among respondents with probable COMISA (AOR 3.24, 95 % CI 1.78–5.87) relative to respondents with no sleep disorder symptoms. The increase in odds for self-reported risk of SI and/or self-harm with probable COMISA compared to insomnia symptoms or high-risk for OSA alone suggests an underlying synergistic effect (Synergy Factor = 2.38). Conclusion: COMISA is associated with increased risk of SI and/or self-harm. Suicide prevention efforts should focus on multimorbidity (two or more physical/mental medical conditions) to identify high-risk groups. |
| format | Article |
| id | doaj-art-c2bb23cc58ad4958a4e9ef6667f08f4d |
| institution | OA Journals |
| issn | 2667-3436 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Sleep Epidemiology |
| spelling | doaj-art-c2bb23cc58ad4958a4e9ef6667f08f4d2025-08-20T01:59:09ZengElsevierSleep Epidemiology2667-34362024-12-01410008810.1016/j.sleepe.2024.100088Increased risk of suicidal ideation and/or self-harm in co-morbid insomnia and obstructive sleep apnea (COMISA)Saurabh Kalra0Nandakumar Nagaraja1Deepak Kalra2Rutgers School of Public Health, Rutgers University, Piscataway, NJ, USA; Corresponding author at: Rutgers School of Public Health, Piscataway, NJ, USA.Department of Neurology, Penn State College of Medicine, Pennsylvania State University, Hershey, PA, USADepartment of Neurology, Penn State College of Medicine, Pennsylvania State University, Hershey, PA, USABackground: Obstructive sleep apnea (OSA) and insomnia are both associated with suicidal ideation (SI), but it is not known if co-morbid insomnia and obstructive sleep apnea (COMISA) has a synergistic effect. We aim to study the association of symptoms of insomnia, OSA, and COMISA with self-reported risk of SI and/or self-harm. Methods: Using cross-sectional data from the National Health and Nutrition Examination Survey (2005–2008) (n = 5,834), we examined the odds of self-reported risk of SI and/or self-harm (past 12-months) with insomnia symptoms, high-risk for OSA, and probable COMISA groups. Insomnia symptoms were identified as having trouble attaining sleep, awakening in between sleep, early awakening on more than 15 nights/month, or diagnosed by physician. High-risk for OSA was assessed by commonly used STOP-Bang questionnaire. Probable COMISA was identified if respondents had both insomnia symptoms and high-risk for OSA. Multiple logistic regression analyses examined the associations, both unadjusted and adjusted for demographics, health behaviors, and depressive symptoms. Results: Self-reported risk of SI and/or self-harm was likely to be more common among respondents with probable COMISA (AOR 3.24, 95 % CI 1.78–5.87) relative to respondents with no sleep disorder symptoms. The increase in odds for self-reported risk of SI and/or self-harm with probable COMISA compared to insomnia symptoms or high-risk for OSA alone suggests an underlying synergistic effect (Synergy Factor = 2.38). Conclusion: COMISA is associated with increased risk of SI and/or self-harm. Suicide prevention efforts should focus on multimorbidity (two or more physical/mental medical conditions) to identify high-risk groups.http://www.sciencedirect.com/science/article/pii/S2667343624000167Sleep apneaDepressionAnxietySuicidal ideationPsychological distressCOMISA |
| spellingShingle | Saurabh Kalra Nandakumar Nagaraja Deepak Kalra Increased risk of suicidal ideation and/or self-harm in co-morbid insomnia and obstructive sleep apnea (COMISA) Sleep Epidemiology Sleep apnea Depression Anxiety Suicidal ideation Psychological distress COMISA |
| title | Increased risk of suicidal ideation and/or self-harm in co-morbid insomnia and obstructive sleep apnea (COMISA) |
| title_full | Increased risk of suicidal ideation and/or self-harm in co-morbid insomnia and obstructive sleep apnea (COMISA) |
| title_fullStr | Increased risk of suicidal ideation and/or self-harm in co-morbid insomnia and obstructive sleep apnea (COMISA) |
| title_full_unstemmed | Increased risk of suicidal ideation and/or self-harm in co-morbid insomnia and obstructive sleep apnea (COMISA) |
| title_short | Increased risk of suicidal ideation and/or self-harm in co-morbid insomnia and obstructive sleep apnea (COMISA) |
| title_sort | increased risk of suicidal ideation and or self harm in co morbid insomnia and obstructive sleep apnea comisa |
| topic | Sleep apnea Depression Anxiety Suicidal ideation Psychological distress COMISA |
| url | http://www.sciencedirect.com/science/article/pii/S2667343624000167 |
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