Relationship between insomnia symptoms and suicidal ideation: the moderating roles of adverse childhood experience and sex

Pratt, Keltie J. (2023) Relationship between insomnia symptoms and suicidal ideation: the moderating roles of adverse childhood experience and sex. Doctoral (PhD) thesis, Memorial University of Newfoundland.

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Abstract

Data on adverse childhood experiences (ACEs), insomnia, suicidal ideation, and sex was extracted from 2012 cycle of the Canadian Community Health Survey-Mental health (CCHS-MH). The CCHS-MH is a national, cross-sectional survey that collected data to examine the links between mental health and social, demographic, geographic, and economic variables of Canadians. Participants were 2,687 respondents across Canada with complete data on questions pertaining to adverse childhood experiences, insomnia symptoms, and past 12-month suicidal ideation. Results indicated that 78% of the sample endorsed experiencing suicidal ideation within the past 12-months and 29% of the sample indicated currently experiencing insomnia symptoms (i.e., difficulty falling asleep or staying asleep most of the time/all of the time). Regarding ACEs, 29.7% of the sample endorsed never experiencing any type of childhood adversity while 50.7% endorsed experiencing between 1 and 3 adversities, and 19.6% endorsed experiencing 4 or more types of adversity. A single moderator analysis was conducted using PROCESS to examine whether the relationship between insomnia symptoms and past 12-month suicidal ideation is moderated by the number of types of ACEs experienced. The overall model was significant suggesting that individuals who experience more types of adversity will experience a stronger effect of insomnia symptoms on suicidal ideation. A moderated moderation analysis was also conducted. The overall model was significant; however, the three-way interaction was not significant, suggesting biological sex does not moderate the relationship between ACEs, insomnia symptoms, and suicidal ideation. These findings suggest that ACEs should be considered clinically when individuals present with challenges related to insomnia and that multi-modal treatment of insomnia may be beneficial at reducing the impact of ACEs and likelihood of suicide related behaviours.

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