Sleep-related drugs utilization and suicide behaviors: a population-based study in China

Previous studies have yielded conflicting findings regarding the relationship between the use of sleep-related drugs (SRDU) and suicidal behaviors. This population-based study aimed to analyze the associations between SRDU and suicidal behaviors. Additionally, we examined the associations between SRDU and specific conditional suicidal behaviors, providing insights into the impact of SRDU on the progression of suicidal behaviors.

The study was conducted among community residents aged 18 and older using a cross-sectional design, analyzing 21,376 participants. Data on SRDU, suicidal ideation, plans, and attempts were collected. Participants were categorized into general individuals without suicidal behaviors (GNS), suicidal ideators without a plan or attempt (SINPA), suicidal ideators with a plan but no attempt (SIP), and individuals who attempted suicide (SA). Insomnia, sleep apnea, rapid eye movement sleep behavior disorder (RBD), and narcolepsy were assessed using the Athens Insomnia Scale, Berlin Questionnaire, Rapid Eye Movement Sleep Behavior Disorder Questionnaire, and Ullanlinna Narcolepsy Scale, respectively.

After adjusting for sociodemographic variables, insomnia, sleep apnea, RBD, and narcolepsy, SRDU showed a positive association with suicidal ideation (OR = 3.02), plans (OR = 4.78), and attempts (OR = 6.40; all p < 0.001). Compared to GNS, and after controlling for the same variables, SRDU was associated with SINPA (OR = 2.46), SIP (OR = 5.11), and SA (OR = 6.93; all p < 0.001) respectively. However, no significant differences in SRDU were found between SINPA, SIP, and SA (all p > 0.05).

This population-based study confirms that SRDU is positively associated with suicidal ideation, plans, and attempts, even after accounting for the risk factors of insomnia, sleep apnea, RBD, and narcolepsy. Nonetheless, SRDU does not appear to influence the progression from suicidal ideation to attempt.