What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Suicidal ideation and Obstructive Sleep Apnea (n=3447). Intervention: High Obstructive Sleep Apnea (OSA) risk vs. Low OSA risk. Primary outcome: Prevalence of past-year suicidal ideation (p=0.158).

What does this research mean for the field?

Depression and anxiety are consistently associated with suicidal ideation across obstructive sleep apnea (OSA) risk groups, whereas specific behavioral and social factors, such as smoking and not sharing meals, correlate with suicidal ideation specifically in high-risk OSA populations. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This research aims to identify biopsychosocial correlates of suicidal ideation among adults at varying risks of obstructive sleep apnea.

June 3, 2026Open Access

Biopsychosocial Correlates of Suicidal Ideation across Obstructive Sleep Apnea Risk Groups in Korean Adults: A Cross-sectional Secondary Analysis of the 2022~2023 Korea National Health and Nutrition Examination Survey

Key Result

High obstructive sleep apnea risk was not associated with a significantly higher prevalence of suicidal ideation compared to low risk (4.0% vs 3.1%), though depression and anxiety were consistently strong correlates in both groups.

Key Points

This research aims to identify biopsychosocial correlates of suicidal ideation among adults at varying risks of obstructive sleep apnea.
Cross-sectional secondary analysis of data from the 2022-2023 Korea National Health and Nutrition Examination Survey.
Participants were categorized into low and high risk for obstructive sleep apnea using the STOP-Bang questionnaire.
Multivariable logistic regression analyses were conducted to assess associations in each OSA risk group.
Suicidal ideation prevalence was 3.1% in the low-risk group and 4.0% in the high-risk group.
Absence of depressive symptoms was associated with lower odds of suicidal ideation (high-risk: AOR=0.28, low-risk: AOR=0.11).
Higher anxiety levels were linked to increased odds (high-risk: AOR=4.95, low-risk: AOR=5.21).

Study Design

Type

Cross-Sectional (n=3,447)

Structured PICO

What are the biopsychosocial correlates of suicidal ideation across obstructive sleep apnea risk groups in Korean adults?

Population

3,447 Korean adults aged 40 years and older from a national health survey were assessed to identify biopsychosocial correlates of suicidal ideation across obstructive sleep apnea risk groups.

Outcome

Past-year suicidal ideation (self-reported)patient reported

Depression and anxiety are consistent correlates of suicidal ideation regardless of OSA risk, while specific behavioral and social factors like smoking and not sharing meals are uniquely associated in high-risk OSA patients.

Main Result

Absolute Event Rate: 4% vs 3.1%

p-value: p=0.158

Limitations

Cross-sectional design precludes temporal inference
OSA risk was classified by the STOP-Bang questionnaire rather than polysomnography, introducing potential misclassification
Suicidal ideation was measured with a single past-year item that does not capture severity or chronicity
12-month recall period may introduce recall bias
Information on psychiatric and sleep treatment was unavailable
Sparse-data instability due to the limited number of suicidal ideation events relative to model parameters

Abstract

Purpose: Suicidal ideation is associated with multiple biopsychosocial conditions. Obstructive sleep apnea(OSA) is a common sleep-related condition that coexist with psychological, behavioral, and social factors. However, population-based evidence describing correlates of suicidal ideation across OSA risk groups remains limited. Methods: This cross-sectional secondary analysis used data from the 2022-2023 Korea National Health and Nutrition Examination Survey. OSA risk was classified using the STOP-Bang questionnaire as low (0~2) or high (≥3). Past-year suicidal ideation was self-reported. Multivariable logistic regression analyses accounting for complex sampling design were conducted separately within each OSA risk group. Results: Among 3,447 adults aged ≥40 years, suicidal ideation prevalence was 3.1% in the low-risk group and 4.0% in the high-risk group. Absence of depressive symptoms was associated with lower odds in both groups (high-risk: AOR=0.28, low-risk: AOR=0.11), whereas higher anxiety was associated with higher odds(high-risk: AOR=4.95, low-risk: AOR=5.21). In the high-risk group, current smoking (AOR=3.57) and not sharing meals (AOR=2.97) were additionally associated. In the low-risk group, short sleep duration (AOR=2.41), mental health consultation(AOR=4.20), and older age (AOR=0.26) were observed. Biological indicators were not significant after adjustment. Conclusion: Depression and anxiety were consistently associated with suicidal ideation across OSA risk groups. Additional behavioral, social, and sleep-related factors were observed within specific groups, although these findings reflect descriptive patterns rather than statistically confirmed heterogeneity. Incorporating sleep-related health context may enhance population-level suicide risk assessment and support subgroup identification for targeted screening. Longitudinal studies are needed to clarify temporal relationships and mechanisms.

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