Abstract：
Recent research shows that sleep disturbances are linked to increased suicidal ideation. In the present longitudinal cohort study, we used subjective (ecological momentary assessment, EMA) and objective (actigraphy) measures to examine the effects of sleep parameters on next-day suicidal ideation. Further, we examined hopelessness as a mediator between insufficient sleep and increased suicidal ideation. Individuals with current suicidal ideation (N = 82) completed 21 days of EMA and actigraphy to estimate suicidal ideation, hopelessness and sleep parameters. Multilevel linear-mixed models were used to examine the effects of sleep parameters on next-day suicidal ideation, as well as for the mediating effect of hopelessness (in the morning) on the association between previous night\'s sleep and suicidal ideation levels the next day. Significant concordance existed between subjective and objective sleep measures, with moderate-to-large correlations (r = 0.44-0.58). Lower subjective sleep quality and efficiency, shorter total sleep time and increased time awake after sleep onset were significantly associated with increased next-day suicidal ideation (controlling for previous-day suicidal ideation). Actigraphy-measured sleep fragmentation was also a significant predictor of next-day ideation. Hopelessness mediated the effects of the subjective sleep parameters on suicidal ideation, but did not account for the association with sleep fragmentation. Therefore, individuals\' psychological complaints (hopelessness, suicidal ideation) were better predicted by subjective sleep complaints than by objective sleep indices. Increased hopelessness following from perceived insufficient sleep appears an important explanatory factor when considering the link between sleep disturbances and suicidal ideation.
摘要：
最近的研究表明，睡眠障碍与自杀意念的增加有关。在目前的纵向队列研究中，我们使用主观(生态瞬时评估，EMA）和客观（活动记录）措施，以检查睡眠参数对第二天自杀意念的影响。Further,我们研究了绝望作为睡眠不足和自杀意念增加之间的中介。具有当前自杀意念的个体（N=82）完成了21天的EMA和活动记录以估计自杀意念，绝望和睡眠参数。使用多级线性混合模型来检查睡眠参数对第二天自杀意念的影响，以及绝望（早上）对前一天晚上睡眠和第二天自杀意念水平之间的关联的中介作用。主观和客观睡眠测量之间存在显着的一致性，具有中等到大的相关性(r=0.44-0.58)。降低主观睡眠质量和效率，较短的总睡眠时间和睡眠发作后清醒时间的增加与次日自杀意念的增加(控制前一天的自杀意念)显著相关.活动力描记法测量的睡眠碎片也是第二天观念的重要预测指标。绝望介导了主观睡眠参数对自杀意念的影响，但没有解释与睡眠碎片的关联。因此,个人心理抱怨(绝望，自杀意念）通过主观睡眠投诉比通过客观睡眠指数更好地预测。当考虑睡眠障碍与自杀意念之间的联系时，由于感知到的睡眠不足而导致的绝望感增加似乎是一个重要的解释因素。
