ArticleSleep2021
Insomnia in the context of short sleep increases suicide risk.
Article in Sleep, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04986007 (Addressing Nocturnal Sleep/Wake Effects on Risk of Suicide in Older Adults), which is not on this map. Cited by 24 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Addressing Nocturnal Sleep/Wake Effects on Risk of Suicide in Older Adults (ANSWERS-OA): A Pilot, Open-Label, Randomized Controlled Trial of Digital Cognitive Behavioral Therapy for Insomnia
Who cites it
24 citing papers in PubMed, 43 citations in OpenAlex.
- Suicide and Sleep Disorders: The Role of Insomnia, Nightmares, and Circadian Disruption.Cureus · 2026Review
- Suicidal Ideation Following a Single Dose of Melatonin in a Patient With Major Depressive Disorder: A Case Report.Clinical case reports · 2026Article
- Berbamine Targets TNFAIP3: A Bioactive Compound Alleviates Oxidative Stress and Inflammation in the Comorbidity of Insomnia and Chronic Obstructive Pulmonary Disease Through Multi-Omics Integration.International journal of molecular sciences · 2025Article
- Gender-specific associations of blood immune markers with symptoms and cognitive function in major depressive disorder: a cross-sectional observational study.BMC psychiatry · 2025Observational
- Sleep-related drugs utilization and suicide behaviors: a population-based study in China.BMC public health · 2025Article
- Differential directional effects between insomnia symptoms and suicidal ideation across trait depression levels: a cross-lagged network analysis among Chinese medical undergraduates.Frontiers in psychiatry · 2025Article
- Associations of physical activity and sedentary behavior with insomnia in middle-aged and older adults: a cross-sectional study.Frontiers in public health · 2025Article
- Phenome-wide diagnostic comparison among suicide deaths and living individuals with chronic pain diagnoses.BMC medicine · 2024Article
- The Association between Suicidal Ideation and Subtypes of Comorbid Insomnia Disorder in Apneic Individuals.Journal of clinical medicine · 2024Article
- Unintended consequences: college students' melatonin usage, sleep disturbance, and depressive symptoms.Sleep and biological rhythms · 2024Article
- [Insomniac symptoms and suicidality-link and management].Neuropsychiatrie : Klinik, Diagnostik, Therapie und Rehabilitation : Organ der Gesellschaft Osterreichischer Nervenarzte und Psychiater · 2024Review
- A genome-wide association study identifies candidate genes for sleep disturbances in depressed individuals.Human genomics · 2024Article
- UPLC-Q-TOF-MS/MS Combined with Network Pharmacology, Molecular Docking, and Animal Verification Reveals the Mechanism of Insomnia Treatment by Shen Qi Wu Wei Zi Capsules.Combinatorial chemistry & high throughput screening · 2024Article
- The mediating role of impulsivity between sleep quality and suicidal ideation in adolescent population: a multicenter cross-sectional study in the northeastern Sichuan, China.Frontiers in psychiatry · 2024Article
- Longitude-based time zone partitions and rates of suicide.Journal of affective disorders · 2023Article
- Examining sleep disturbance components as near-term predictors of suicide ideation in daily life.Psychiatry research · 2023Article
- Sub-types of insomnia in adolescents: Insights from a quantitative/molecular twin study.JCPP advances · 2023Article
- Effects of sleep quality on suicide risk in COVID-19 patients: The chain mediating of anxiety and depressive symptoms.Heliyon · 2023Article
- Verification of sleep scales as predictors of suicidal ideation in Japanese dayworkers: a longitudinal study.Sleep and biological rhythms · 2022Article
- Eyes wide open: sleep disturbance, not melatonin, is the real issue to address for suicide risk.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
objectivesThe relationship between insomnia and suicide risk is not completely understood. We aimed to investigate the influence of insomnia on suicide risk, taking both sleep duration and depression into consideration.
methodsThe present study is based on a Swedish prospective cohort study of 38,786 participants with a mean follow-up time of 19.2 years. Cox proportional hazards models with attained age as time-scale were used to estimate hazard ratios (HRs) of death by suicide with 95% confidence intervals (CI) for participants categorized by frequency of insomnia symptoms. Causal mediation analysis was performed to assess to what extent the relationship between insomnia and suicide risk is mediated by depression.
resultsInsomnia was only associated with suicide risk among short sleepers, whereas no significant association was observed among those who slept 7 h/night or more. The total effect of insomnia in the context of short sleep on suicide risk, expressed on the HR scale, was 2.85 (95% CI 1.42-5.74). The direct effect was 2.25 (95% CI 1.12-4.54) and the indirect effect, mediated by depression, was 1.27 (95% CI 1.05-1.53). Of the total effect, 32% was mediated by depression. The association between insomnia and suicide risk became more pronounced with decreasing depressive symptoms (p value for trend <0.05).
conclusionsInsomnia in the context of short sleep increases suicide risk, both directly and indirectly by affecting the risk of depression. Abnormalities of sleep duration and insomnia symptoms should be evaluated when assessing suicide risk.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.