An actigraphy case series: Sleep disturbance associations with suicidal ideation, self-harm and desire to live

Abstract

Introduction

Sleep disturbances are a well-established suicide risk factor. This case series represents an investigation into the individual-level associations between objectively measured sleep using actigraphy and fatigue on next-day suicidal ideation, self-harm urges, and desire to be alive.

Methods

This case series utilizes data from seven adults with borderline personality disorder receiving dialectical behavioral therapy (DBT). Participants wore a Phillips HealthBand wearable device to collect actigraphy data and completed ecological momentary assessment (EMA). Data was collected for one week per month for each of the six months of treatment. We conducted a series of individual linear regressions.

Results

For participant 1, fatigue was associated with self-injury urges. Sleep duration and time in bed were predictive of desire to be alive. For participant 3, fatigue was associated with suicidal ideation. Sleep efficiency was predictive of desire to be alive. Participant 5′s WASO was predictive of suicidal ideation and desire to be alive. For participant 6, WASO predicted desire to be alive. For participant 7, fatigue was predictive of desire to be alive.

Discussion

This case series provides evidence that certain aspects of sleep, as measured by actigraphy, is predictive of SI, self-harm urges, and desire to be alive among certain DBT patients. Results points to the importance of examining actigraphy findings on an individual level. Future research should continue to utilize multimodal data to advance understanding of the associations between sleep metrics with STBs, as well as how to continue to best leverage actigraphy data in combination with other methodologies.