TY - JOUR
T1 - Nocturnal Wakefulness and Suicide Risk in the Australian Population
AU - Mansfield, Darren R.
AU - Wasgewatta, Sanjiwika
AU - Reynolds, Amy
AU - Grandner, Michael A.
AU - Tubbs, Andrew S.
AU - King, Kylie
AU - Johnson, Michael
AU - Mascaro, Luis
AU - Durukan, Melodi
AU - Paul, Eldho
AU - Drummond, Sean P.A.
AU - Perlis, Michael L.
N1 - Funding Information:
This study was supported by an unrestricted grant by Rhinomed LTD Australia. The authors wish to acknowledge Sara Bowditch, RN, Department of Lung and Sleep, Monash Health, Melbourne, Australia, for data analysis and entry. The authors also wish to acknowledge Sarah Appleton, PhD, Robert Adams MD, and co-workers of the Adelaide Institute for Sleep Health, Flinders University, Adelaide, Australia, for access to survey data from the population sample of Australian adults. No conflict of interest pertains to those acknowledged.
Funding Information:
Submitted: October 4, 2021; accepted January 3, 2022. Published online: June 22, 2022. Relevant financial relationships: Prof Mansfield and Mr Johnson received funding support from Rhinomed LTD in the production of this manuscript, and Mr Johnson is employed by Rhinomed LTD. Dr Wasgewatta, Dr Reynolds, Dr Grandner, Mr Tubbs, Dr King, Mr Mascaro, Ms Durukan, Dr Paul, Dr Drummond, and Dr Perlis have no conflicts of interest to disclose. Funding support: This study was supported by an unrestricted grant by Rhinomed LTD Australia. Role of the sponsor: Mr Johnson is employed by Rhinomed LTD, who assisted in study conceptualization. Rhinomed LTD had no influence over study execution, analysis, or interpretation of findings. Acknowledgements: The authors wish to acknowledge Sara Bowditch, RN, Department of Lung and Sleep, Monash Health, Melbourne, Australia, for data analysis and entry. The authors also wish to acknowledge Sarah Appleton, PhD, Robert Adams MD, and co-workers of the Adelaide Institute for Sleep Health, Flinders University, Adelaide, Australia, for access to survey data from the population sample of Australian adults. No conflict of interest pertains to those acknowledged. Additional information: The Australian National Coronial Information System database (https:// www.ncis.org.au) is maintained by the Victorian state coroner. It is a confidential database that is accessible upon request for the purposes of research by a recognized research institute. Approvals for access to the database requires a research submission to the Victorian state coroner including ethics approval from local institute.
Publisher Copyright:
© 2022 Physicians Postgraduate Press, Inc.
PY - 2022
Y1 - 2022
N2 - Objective: Temporal patterns for suicide over a 24-hour period have shown mixed results among prior studies. However, analyses of 24-hour temporal patterns for wakeful actions including suicidal behavior should adjust for expected sleep requirements that inherently skew such activities to conventional wakeful times. This study analyzed the time-of-day for suicide cases from the Australian population for the year 2017, adjusting for expected sleep patterns. Identification of time-of-day trends using this methodology may reveal risk factors for suicide and potentially modifiable contributors. Methods: The Australian National Coronial Information System database was accessed, and data for completed suicide were extracted for the most recent completed year (2017). Time of suicide was allocated to one of four 6-hourly time bins across 24 hours, determined from time last seen alive and time found subsequently. Prevalence of suicide for each time bin was adjusted for the likelihood of being awake for each bin according to sleep-wake norms published from a large Australian community survey. Observed prevalence of suicide was compared to expected values predicted from likelihood of being awake across each time bin calculated as a standardized incidence ratio (SIR). Results: For the year 2017, there were 2, 808 suicides, of which 1, 417 were able to be allocated into one of four 6-hourly time bins. When compared to expected values, suicides were significantly more likely to occur in the overnight bin (2301-0500; SIR = 3.93, P < .001). Conclusions: Higher-than-expected rates of suicide overnight associated with nocturnal wakefulness may represent a modifiable risk factor for triggering suicide events.
AB - Objective: Temporal patterns for suicide over a 24-hour period have shown mixed results among prior studies. However, analyses of 24-hour temporal patterns for wakeful actions including suicidal behavior should adjust for expected sleep requirements that inherently skew such activities to conventional wakeful times. This study analyzed the time-of-day for suicide cases from the Australian population for the year 2017, adjusting for expected sleep patterns. Identification of time-of-day trends using this methodology may reveal risk factors for suicide and potentially modifiable contributors. Methods: The Australian National Coronial Information System database was accessed, and data for completed suicide were extracted for the most recent completed year (2017). Time of suicide was allocated to one of four 6-hourly time bins across 24 hours, determined from time last seen alive and time found subsequently. Prevalence of suicide for each time bin was adjusted for the likelihood of being awake for each bin according to sleep-wake norms published from a large Australian community survey. Observed prevalence of suicide was compared to expected values predicted from likelihood of being awake across each time bin calculated as a standardized incidence ratio (SIR). Results: For the year 2017, there were 2, 808 suicides, of which 1, 417 were able to be allocated into one of four 6-hourly time bins. When compared to expected values, suicides were significantly more likely to occur in the overnight bin (2301-0500; SIR = 3.93, P < .001). Conclusions: Higher-than-expected rates of suicide overnight associated with nocturnal wakefulness may represent a modifiable risk factor for triggering suicide events.
UR - http://www.scopus.com/inward/record.url?scp=85139786075&partnerID=8YFLogxK
U2 - 10.4088/JCP.21m14275
DO - 10.4088/JCP.21m14275
M3 - Article
C2 - 35759782
AN - SCOPUS:85139786075
SN - 0160-6689
VL - 83
JO - Journal of Clinical Psychiatry
JF - Journal of Clinical Psychiatry
IS - 4
M1 - 21m14275
ER -