The Network Ties between Sleep Quality, Suicidality, and Psychopathology

Introduction: In recent years, growing attention has been given to the role of sleep disturbances in mental health outcomes, assuming a potential link between sleep problems and suicidality. This study applies a network analysis to examine how sleep quality is interconnected with suicidal thoughts and behaviors, as well as with a range of psychopathological symptoms.

A total sample of 1,674 participants (75.3% female, 24.7% male) from the general population were investigated and completed standardized assessments of sleep quality and psychopathological symptoms. A regularized cross-sectional partial correlation network between sleep quality (Pittsburgh Sleep Quality Index [PSQI]), suicidality (Scale for Suicidal Experience and Behavior [SSEV]), and psychopathological symptoms (Brief Symptom Inventory [BSI-18]) was estimated using the EBICglasso algorithm. Node centrality, predictability, and bridge centrality were evaluated, and bootstrap methods were employed to test the stability and significance of the network structure.

The network was found to be stable, supporting reliable interpretations. Active suicide thoughts, anxiety, and subjective sleep quality were found to be the most influential nodes within the investigated psychopathological network. Depression and daytime impairment due to poor sleep quality were observed as nodes with the highest bridge centrality.

These findings highlight that depression and, importantly, daytime functioning related to poor sleep quality play a central role in linking suicidality and sleep quality. This emphasizes the need to address not only nighttime sleep problems but also daytime impairments as key clinical targets. Prioritizing interventions that improve sleep and restore daytime functioning may therefore be crucial in suicide prevention and clinical care.