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Updated: Oct 28, 2025

Author Spotlight: Unveiling the Connection Between Sleep Disorders and Cognitive Symptoms in Depression
Published on: April 26, 2024
Sleep Disturbances and the Risk of Incident Suicidality: A Systematic Review and Meta-Analysis of Cohort Studies
1From the Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Dong), Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China; Team IETO, Bordeaux Population Health Research Center, UMR U1219, INSERM (Lu), Université de Bordeaux, Bordeaux, France; The National Clinical Research Center for Mental Disorders, the Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, and the Advanced Innovation Center for Human Brain Protection (Sha, L. Zhang, Q. Zhang), Capital Medical University, Beijing, China; Division of Psychiatry, School of Medicine (Ungvari), University of Western Australia/Graylands Hospital, Perth; University of Notre Dame Australia (Ungvari), Fremantle, Australia; Department of Psychiatry, University of Saskatchewan (Balbuena), Saskatoon, Saskatchewan, Canada; Unit of Psychiatry, Department of Public Health and Medicinal Administration, Faculty of Health Sciences (Xiang), Centre for Cognitive and Brain Sciences (Xiang), and Institute of Advanced Studies in Humanities and Social Sciences (Xiang), University of Macau, Macao SAR, China.
Objective:
The association between sleep disturbances and suicidality is not well understood partly because of the variability in research results. This meta-analysis aimed to investigate the predictive value of sleep disturbances for incident suicidality.
Methods:
A systematic search was conducted in PubMed, EMBASE, PsycINFO, and Web of Science databases for studies examining sleep disturbances and incident suicidality. Cohort studies were screened following a registered protocol, and the eligible ones were meta-analyzed.
Results:
Seven studies comprising 1,570,181 individuals at baseline, with 1407 attempting suicide and 1023 completing suicide during follow-up, were included. Individuals with baseline sleep disturbances had a significantly higher incidence of suicidality than did those without (relative risk = 2.17, 95% confidence interval [CI] = 1.45-3.24, I2 = 82.50%, p < .001). The risk of an incident suicide attempt was 3.54-fold higher (95% CI = 3.07-4.09, I2 = 0%, p = .44), whereas the risk of incident completed suicide was 1.80-fold higher (95% CI = 1.32-2.44, I2 = 59.33%, p = .01) in individuals with baseline sleep disturbances.
Conclusions:
Incident suicide attempts and deaths are higher among people with sleep disturbances. Regular screening and preventive measures should be undertaken for people with sleep disturbances to prevent progression into suicide attempts and deaths.Clinical Trial Registration:CRD42019136397.
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