Sleep and Suicide: A Systematic Review and Meta-Analysis of Longitudinal Studies

Authors

Richard T. Liu, Massachusetts General Hospital
Stephanie J. Steele, Williams CollegeFollow
Jessica L. Hamilton, University of Pittsburgh School of Medicine
Quyen B.P. Do, University of Pittsburgh
Kayla Furbish, Boston University
Taylor A. Burke, The Warren Alpert Medical School
Ashley P. Martinez, The Warren Alpert Medical School
Nimesha Gerlus, Duke University School of Medicine

Document Type

Article

Publication Date

11-1-2020

Publication Title

Clinical Psychology Review

Abstract

The current review provides a quantitative synthesis of the empirical literature on sleep disturbance as a risk factor for suicidal thoughts and behaviors (STBs). A systematic search of PsycINFO, MEDLINE, and the references of prior reviews resulted in 41 eligible studies included in this meta-analysis. Sleep disturbance, including insomnia, prospectively predicted STBs, yielding small-to-medium to medium effect sizes for these associations. Complicating interpretation of these findings however, is that few studies of suicidal ideation and suicide attempts, as well as none of suicide deaths, assessed short-term risk (i.e., employed follow-up assessments of under a month). Such studies are needed to evaluate current conceptualizations of sleep dysregulation as being involved in acute risk for suicidal behavior. This want of short-term risk studies also suggests that current clinical recommendations to monitor sleep as a potential warning sign of suicide risk has a relatively modest empirical basis, being largely driven by cross-sectional or retrospective research. The current review ends with recommendations for generating future research on short-term risk and greater differentiation between acute and chronic aspects of sleep disturbance, and by providing a model of how sleep disturbance may confer risk for STBs through neuroinflammatory and stress processes and associated impairments in executive control.

Keywords

Insomnia, Meta-analysis, Sleep, Suicidal ideation, Suicide

Volume

81

DOI

10.1016/j.cpr.2020.101895

ISSN

02727358

Comments

Peer reviewed accepted manuscript.

Recommended Citation

Liu, Richard T.; Steele, Stephanie J.; Hamilton, Jessica L.; Do, Quyen B.P.; Furbish, Kayla; Burke, Taylor A.; Martinez, Ashley P.; and Gerlus, Nimesha, "Sleep and Suicide: A Systematic Review and Meta-Analysis of Longitudinal Studies" (2020). Psychology: Faculty Publications, Smith College, Northampton, MA.
https://scholarworks.smith.edu/psy_facpubs/177