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      Pre-COVID-19 short sleep duration and eveningness chronotype are associated with incident suicidal ideation during COVID-19 pandemic in medical students: a retrospective cohort study

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          Abstract

          Introduction

          Cross-sectional evidence suggests that sleep problems increased the risk of suicide during the 2019 coronavirus disease (COVID-19) pandemic. However, a lack of longitudinal studies examined the relationship between pre-COVID-19 sleep duration, chronotype and incident suicide during the COVID-19 pandemic. Thus, we examined these associations in a longitudinal study of medical students.

          Methods

          From the Shantou College Student Sleep Cohort, a total of 333 first and second grade medical students (age 19.41 ± 0.82 years, female 61.26%), without suicidal ideation (SI) at pre-COVID-19 period, were followed up during the COVID-19 pandemic. Incident SI was defined by their response to the 9 th question from the Beck Depression Inventory. Short sleep duration was defined as less than 7 h/night. The Morningness-Eveningness Questionnaire was used to evaluate the participants’ chronotype. Logistic regression with adjusted odds ratios (AOR) and 95% confidence intervals (95% CI) was used to examine the association between sleep and SI.

          Results

          The incidence of SI during the COVID-19 pandemic was 5.71%. Logistic regressions with confounding factors adjustment showed that both short sleep duration (AOR = 4.91, 95% CI = 1.16–20.74) and eveningness (AOR = 3.80, 95% CI = 1.08–13.30) in the pre-COVID-19 period were associated with increased risk of incident SI during the COVID-19 pandemic.

          Conclusion

          Pre-COVID-19 short sleep duration and eveningness predict incident SI during the COVID-19 pandemic in medical students. Prolonging sleep duration may help to decrease SI during major public health crises.

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          Most cited references59

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          The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research

          Daniel J. Buysse, Charles Reynolds III, Timothy H Monk … (1989)
          Despite the prevalence of sleep complaints among psychiatric patients, few questionnaires have been specifically designed to measure sleep quality in clinical populations. The Pittsburgh Sleep Quality Index (PSQI) is a self-rated questionnaire which assesses sleep quality and disturbances over a 1-month time interval. Nineteen individual items generate seven "component" scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The sum of scores for these seven components yields one global score. Clinical and clinimetric properties of the PSQI were assessed over an 18-month period with "good" sleepers (healthy subjects, n = 52) and "poor" sleepers (depressed patients, n = 54; sleep-disorder patients, n = 62). Acceptable measures of internal homogeneity, consistency (test-retest reliability), and validity were obtained. A global PSQI score greater than 5 yielded a diagnostic sensitivity of 89.6% and specificity of 86.5% (kappa = 0.75, p less than 0.001) in distinguishing good and poor sleepers. The clinimetric and clinical properties of the PSQI suggest its utility both in psychiatric clinical practice and research activities.
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            J ERBAUGH, J. Mock, A. Beck … (1961)
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                Author and article information

                Contributors
                Dandan Zheng: URI : https://loop.frontiersin.org/people/2790024/overviewRole: Role: Role: Role: Role: Role:
                Qingsong Qin: URI : https://loop.frontiersin.org/people/1053825/overviewRole: Role: Role: Role:
                Yingyin Peng: Role: Role: Role: Role:
                Hao Zhong: Role: Role: Role: Role:
                Yerui Huang: Role: Role: Role: Role:
                Hongjie Wang: Role: Role: Role: Role:
                Qiqing Tan: Role: Role: Role: Role:
                Yun Li: URI : https://loop.frontiersin.org/people/1258462/overviewRole: Role: Role: Role: Role: Role:
                Journal
                Journal ID (nlm-ta): Front Public Health
                Journal ID (iso-abbrev): Front Public Health
                Journal ID (publisher-id): Front. Public Health
                Title: Frontiers in Public Health
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 2296-2565
                Publication date (Electronic): 23 July 2024
                Publication date Collection: 2024
                Volume: 12
                Electronic Location Identifier: 1406396
                Affiliations
                [1] 1Department of Sleep Medicine, Mental Health Center of Shantou University , Shantou, Guangdong, China
                [2] 2Sleep Medicine Center, Shantou University Medical College , Shantou, Guangdong, China
                [3] 3Faculty of Medicine of University of Manitoba Joint Laboratory of Biological Psychiatry, Shantou University Medical College , Shantou, Guangdong, China
                [4] 4Laboratory of Human Virology and Oncology, Shantou University Medical College , Shantou, Guangdong, China
                Author notes

                Edited by: Janaina Minelli De Oliveira, University of Rovira i Virgili, Spain

                Reviewed by: Shayan Shahrokhi, University of Calgary, Canada

                María José Serrno-Fernández, University of Rovira i Virgili, Spain

                Dushad Ram, Shaqra University, Saudi Arabia

                Shuang-Jiang Zhou, Peking University HuiLongGuan Clinical Medical School, China

                *Correspondence: Yun Li, s_liyun@ 123456stu.edu.cn
                Article
                DOI: 10.3389/fpubh.2024.1406396
                PMC ID: 11300336
                SO-VID: 26656c2d-b678-4806-a41f-c3ad974b7427
                Copyright © Copyright © 2024 Zheng, Qin, Peng, Zhong, Huang, Wang, Tan and Li.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 22 April 2024
                Date accepted : 08 July 2024
                Page count
                Figures: 3, Tables: 2, Equations: 0, References: 59, Pages: 8, Words: 6750
                Funding
                The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This study was supported by Guangdong University Students Innovation and Entrepreneurship Training Program (201910560138; 202010560040; and S202310560139), National Natural Science Foundation of China (Nos. 81970087 and 82270105), Grant for Key Disciplinary Project of Clinical Medicine under the Guangdong High-level University Development Program and Department of Educational of Guangdong Province (2017KTSCX065) and 2020 Li Ka Shing Foundation Cross-Disciplinary Research Grant (2020LKSFG05B).
                Categories
                Subject: Public Health
                Subject: Original Research
                Custom metadata
                section-at-acceptance Public Mental Health

                Keywords: short sleep duration,chronotype,suicidal ideation,covid-19,medical students
                Data availability:
                Keywords: short sleep duration, chronotype, suicidal ideation, covid-19, medical students

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