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May 14, 2026Open Access

Excessive daytime sleepiness and frequent nightmares are associated with suicidal ideation among psychiatric inpatients

PTPikun TanShantou University JWJun WuShantou University YDYanyuan DaiShantou University

Key Points

This study aims to explore the relationship between excessive daytime sleepiness and frequent nightmares with suicidal ideation among psychiatric inpatients.
Cross-sectional design involving 650 psychiatric inpatients from Shantou University Mental Health Center.
Excessive daytime sleepiness measured using the Epworth Sleepiness Scale, with nightmares assessed via the Pittsburgh Sleep Quality Index.
Suicidal ideation evaluated using the Beck Scale for Suicide Ideation-Chinese Version.
6.00% of patients (39 out of 650) exhibited suicidal ideation.
Patients with suicidal ideation showed significantly higher rates of excessive daytime sleepiness and total ESS scores (p < 0.001).
Those experiencing both excessive daytime sleepiness and frequent nightmares had increased odds for suicidal ideation (OR = 5.203, p = 0.005; OR = 3.077, p = 0.012).

Abstract

Abstract Objectives This study aimed to explore the association between excessive daytime sleepiness (EDS) and frequent nightmares and the risk for suicidal ideation (SI) among psychiatric inpatients. Methods In this cross‐sectional study, 650 inpatients were consecutively recruited from the inpatient department of Shantou University Mental Health Center. EDS was defined as Epworth Sleepiness Scale (ESS) > 10. Frequent nightmares were defined as nightmares ≥1 time per week during past 1 month. Pittsburgh Sleep Quality Index (PSQI) was used to evaluate nightmares and sleep‐related features. Beck Scale for Suicide Ideation‐Chinese Version (BSI‐CV) was used to assess SI. Results Among the 650 inpatients, 39 (6.00%) presented SI. Patients with SI had higher proportion of EDS ( p < 0.001) and total scores of ESS ( p < 0.001) compared to those without SI. Patients with EDS and frequent nightmares had higher odds for SI (OR = 5.203, p = 0.005; OR = 3.077, p = 0.012) after adjusting for the confounders. Similarly, dose–response associations between the higher ESS scores ( p for trend < 0.001), frequent nightmare ( p for trend = 0.014) and higher risk of SI were also observed. Conclusions EDS and frequent nightmares are risk factors for SI among psychiatric inpatients. These findings underscore the importance of assessment and treatment of EDS and frequent nightmares for identifying and mitigating SI among psychiatric inpatients.

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