Key result
Sleep disturbance was significantly associated with suicidal ideation in patients with acute coronary syndrome, and this association at 1-year follow-up was significant only in patients with lower serum serotonin levels.
Why the study?
This study investigated associations of sleep disturbance and serum serotonin levels with suicidal ideation, and evaluated potential modifying effects of serotonin on these associations in ACS patients.
Do sleep disturbance and serum serotonin levels predict suicidal ideation in patients with acute coronary syndrome?
Cohort (n=969)
No
Do sleep disturbance and serum serotonin levels predict suicidal ideation in patients with acute coronary syndrome?
Odds Ratio: 2.14 (95% CI 1.54–2.98)
Absolute Event Rate: 29% vs 14.3%
p-value: p=<0.001
In patients with acute coronary syndrome, sleep disturbance is associated with suicidal ideation, particularly in those with lower serum serotonin levels.
Sleep disturbance may associate with suicidal ideation in ACS via serotonin; hypothesis-generating and requires prospective validation before any clinical inference.
Background: This study investigated the associations of sleep disturbance and serum serotonin levels with suicidal ideation, and evaluated the potential modifying effects of serotonin on these associations in patients with the acute coronary syndrome (ACS). Methods: In total, 969 ACS patients were recruited from a tertiary university hospital in Korea within 2 weeks of disease onset and evaluated in terms of sleep disturbance (using the Leeds Sleep Evaluation Questionnaire), serum serotonin levels, and suicidal ideation (using the "suicidal thoughts" item of the Montgomery-Åsberg Depression Rating Scale). Covariates included sociodemographics, depression, vascular risk factors, and disease severity. After 1 year, 711 patients were re-evaluated in terms of suicidal ideation. Logistic regression analysis was performed with adjustment for covariates. Results: Sleep disturbance was significantly associated with suicidal ideation at baseline and follow-up. Serum serotonin showed no such association but modified the association of sleep disturbance with suicidal ideation such that it was significant only in the lower serum serotonin group, with significant interaction terms obtained after adjustment for relevant covariates. Conclusion: Evaluating sleep disturbance and serum serotonin levels could improve the accuracy of clinical predictions of suicidal ideation in the acute and chronic phases of ACS.
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Kim et al. (2022) conducted a cohort in Acute coronary syndrome (n=969). Sleep disturbance vs. Lower sleep disturbance was evaluated on Suicidal ideation at baseline (MADRS-ST score ≥ 2) (OR 2.14, 95% CI 1.54-2.98, p=<0.001). Sleep disturbance was significantly associated with suicidal ideation in patients with acute coronary syndrome, and this association at 1-year follow-up was significant only in patients with lower serum serotonin levels.
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