Pre-COVID-19 Short Sleep Duration and Eveningness Chronotype are Associated with Incident Suicide Ideation During COVID-19 Pandemic in Medical Students: A Retrospective Cohort Study

Abstract

Abstract Background: Cross-sectional evidence suggests that sleep problems increased the risk of suicide during the 2019 coronavirus disease (COVID-19) pandemic. However, a lack of longitudinal studies examined the relationship between pre-COVID-19 sleep duration, chronotype and incident suicide during the COVID-19 pandemic. Thus, we examined these associations in a longitudinal study of medical students. Methods: From the Shantou College Student Sleep Cohort, a total of 333 first and second grade medical students (age 19.41±0.82 years, female 61.26%), without suicidal ideation (SI) at pre-COVID-19 period, were followed up during the COVID-19 pandemic. Incident SI was defined by their response to the 9th question from the Beck Depression Inventory. Short sleep duration was defined as less than 7 hours/night. The Morningness-Eveningness Questionnaire was used to evaluate the participants’ chronotype. Logistic regression with adjusted odds ratios (AOR) and 95% confidence intervals (95% CI) was used to examine the association between sleep and SI. Results: The prevalence rate of incident SI during the COVID-19 pandemic was 5.71%. Logistic regressions showed that both short sleep duration (AOR=4.91, 95%CI=1.16-20.74) and eveningness (AOR=3.80, 95%CI=1.08-13.30) in the pre-COVID-19 period, after adjusting for confounders, were associated with increased risk of incident SI during the COVID-19 outbreak. Conclusions: Pre-COVID-19 short sleep duration and eveningness are predictors for incident SI during the COVID-19 pandemic in medical students. Prolonging sleep duration may help to decrease SI during major public health crises in medical students.