title: Association of suicidal ideation with poor sleep quality among Ethiopian adults.
abstract: OBJECTIVE
  The objective of this study was to examine the extent to which poor sleep quality is associated with suicidal ideation among Ethiopian adults.
  
  
  METHODS
  A cross-sectional study was conducted among 1054 adults attending outpatient clinical facilities in Ethiopia. Standardized questionnaires were utilized to collect data on demographics, sleep quality, lifestyle, and depression status. Depression and suicidal ideation were assessed using the Patient Health Questionnaire-9 (PHQ-9), while the Pittsburgh Sleep Quality Index (PSQI) questionnaire was utilized to assess sleep quality. Multivariate logistic regression models were fit to estimate adjusted odds ratio (AOR) and 95 % confidence intervals (95 % CI).
  
  
  RESULTS
  The prevalence of suicidal ideation was 24.3 % while poor sleep quality (PSQI global score of >5 vs. ≤5) was endorsed by 60.2 % of participants. After adjustment for confounders including depression, poor sleep quality was associated with more than 3-fold increased odds of suicidal ideation (AOR = 3.59; 95 % CI 2.34-5.51). When assessed as a continuous variable, each 1-unit increase in the global PSQI score resulted in a 20 % increased odds for suicidal ideation, even after adjusting for depression (AOR = 1.20; 95 % CI 1.14-1.27). Participants with both poor sleep quality and depression had much higher odds (AOR = 23.22, 95 % CI 14.10-38.28) of suicidal ideation as compared with those who had good sleep quality and no depression although inferences from this analysis are limited due to the wide 95 % CI.
  
  
  CONCLUSIONS
  Suicidal ideation and poor sleep quality are highly prevalent. Individuals with poor sleep quality have higher odds of suicidal ideation. If confirmed, mental health services need to address sleep disturbances seriously to prevent suicidal episodes.
authors: Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, K505F, Boston, MA, 02115, USA. bgelaye@hsph.harvard.edu.
authors: Bizu
authors: B
authors: Gelaye
authors: Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, K505F, Boston, MA, 02115, USA.
authors: Joseph
authors: J
authors: Okeiga
authors: Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, K505F, Boston, MA, 02115, USA.
authors: Idris
authors: I
authors: Ayantoye
authors: Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
authors: Hanna Y
authors: HY
authors: Berhane
authors: Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
authors: Yemane
authors: Y
authors: Berhane
authors: Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, K505F, Boston, MA, 02115, USA.
authors: Michelle A
authors: MA
authors: Williams
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000523:psychology*; D003906:Developing Countries; D005002:Ethiopia; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000523:psychology*; D059020:Suicidal Ideation; D011795:Surveys and Questionnaires
keywords: Africa; Ethiopia; Sleep quality; Suicidal ideation; Suicide