Sleep Profiles Differentially Linked to Suicide-Related Symptoms

Three distinct sleep-disturbance profiles were associated with elevated odds of active suicidal ideation among 15,396 adult psychiatric outpatients, even after adjustment for age, sex and other psychiatric symptom dimensions. The cross-sectional study found that the associations were not uniform across all suicide-related symptoms, indicating that the severity of sleep disturbance alone did not fully characterize the observed relationships. Researchers at a psychiatric specialist hospital in China used latent profile analysis to identify sleep profiles from seven dimensions of the Pittsburgh Sleep Quality Index.

They then examined associations between those profiles and three Symptom Checklist-90 items: active suicidal ideation, death-related thoughts and guilt. Logistic regression adjusted for age, sex and the other Symptom Checklist-90 dimensions, while false discovery rate correction was used in the statistical analysis. The study population consisted of adult outpatients presenting with sleep complaints, and its cross-sectional design described relationships at a single point rather than demonstrating that sleep disturbances caused the measured symptoms.

After adjustment, the Mild Disturbance, Severe Insomnia and Moderate Non-Medicated profiles each showed modestly elevated odds of active suicidal ideation. Their adjusted odds ratios ranged from 1.22 to 1.25, indicating that the three estimates were similar in magnitude. These results are associations derived from adjusted statistical models; they do not show that membership in a sleep profile causes active suicidal ideation.

Findings for the other two outcomes were more limited. Death-related thoughts had suggested associations with the Medication Use but Functional and Moderate Non-Medicated profiles in exploratory adjusted analyses, but those associations did not remain statistically significant after false discovery rate correction. The overall sleep-profile effect for death-related thoughts was described as marginal.

Guilt showed no significant associations with sleep profiles after adjustment. The findings therefore differed by symptom type: active suicidal ideation was linked to three profiles, whereas the evidence for death-related thoughts was inconclusive after correction and the adjusted associations with guilt were not significant. Because the analysis involved one psychiatric specialist hospital and assessed associations rather than causal effects, the results are most directly applicable to comparable adult psychiatric outpatients with sleep complaints and require cautious interpretation beyond that setting.

Subject of Research: Associations between sleep-disturbance profiles and suicide-related symptoms in adult psychiatric outpatients

Article Title: Heterogeneity in the association between sleep disturbances and suicide‑related symptoms in 15,396 adult outpatients

Article References: Chen, K., Xu, Q., Wen, D., & Xue, J. (2026). Heterogeneity in the association between sleep disturbances and suicide‑related symptoms in 15,396 adult outpatients. BMC Psychiatry. https://doi.org/10.1186/s12888-026-08780-w

Image Credits: AI Generated

DOI: 10.1186/s12888-026-08780-w

Keywords: sleep disturbances, suicidal ideation, death-related thoughts, guilt, latent profile analysis, PSQI, psychiatric outpatients, cross-sectional study, mental health, Heterogeneity, association, between