Suicidal ideation and its relationship with obstructive sleep apnea severity, sleep-related problems and social support

Abstract

Background: Recently, an increased level of Suicidal Ideation (SI) has been observed in Obstructive Sleep Apnea (OSA) patients. Social support has been shown of relevance in many chronic diseases, and is supposed to decrease Suicidal Ideation (SI). However, evidence lacks on the association between sleep-related problems and social support with SI in OSA patients. Therefore, we aimed to assess the prevalence of SI in OSA patients and to examine the relationships between OSA severity, sleep-related problems, social support and SI. Methods: We included 149 patients (68% male; mean age 48.99±9.57 years) with the diagnosis of OSA (Apnea-Hypopnea Index–AHI≥5) based on a full-night polysomnography. All patients completed the General Health Questionnaire-28 SI subscale, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, the Multidimensional Fatigue Inventory, and the Multidimensional Scale of Perceived Social Support. Structural equation modeling (SEM) was used to analyze the data. Findings: The prevalence of SI among OSA patients was 20%. Patients reporting SI scored poorer on sleep quality and fatigue, compared to the non-SI patients. SEM showed fatigue to be most strongly related to SI (β=0.49; p<0.001). No relationship between social support and SI in OSA patients was found. Discussion: SI in OSA is strongly related to poor sleep quality and high fatigue levels. Understanding the pathways among these symptoms and SI in OSA patients is important as it may contribute to better disease management. [Grant support: APVV-15-0719].