The Association Between Sleep Disturbance and Suicidality in
Psychiatric Inpatients Transitioning to the Community: Protocol
for an Ecological Momentary Assessment Study
Psychiatric Inpatients Transitioning to the Community: Protocol
for an Ecological Momentary Assessment Study
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Background:
Patients are at high risk of suicidal behaviour and death by suicide immediately following
discharge from an inpatient psychiatric hospital. Furthermore, there is a high prevalence of
sleep problems in inpatient settings which is associated with worse outcomes following
hospitalisation. However, it is unknown whether poor sleep is associated with suicidality
following initial hospital discharge.
Objective:
Our study objective is to describe the ecological momentary assessment (EMA) study
protocol that aims to examine the relationship between sleep and suicidality in discharged
patients.
Methods:
Our study will use EMA design using a wearable device to examine the sleep-suicide
relationship during the transition from acute inpatient care to the community. Prospectively
discharged inpatients aged 18-35 with a mental disorder (n=50) will be assessed for
eligibility and recruited across two sites. Data on suicidal ideation, behaviour and imagery,
non-suicidal self-harm and imagery, defeat, entrapment, and hopelessness, affect and sleep
will be collected on the Pro-Diary V wrist-worn electronic watch for up to 14 days. Objective
sleep and daytime activity will be measured using the inbuilt MotionWare software.
Questionnaires will be administered face-to-face at baseline and follow-up while data will
also be collected on the acceptability and feasibility of using the Pro-Diary V watch to
monitor the transition following discharge. The study has been, and will continue to be, coproduced with young people with experience of being in an inpatient setting and suicidality.
Results:
South Birmingham Research Ethics Committee (Ref: 21/WM/0128) approved the study on
June 28th 2021. We expect to see a relationship between poor sleep and post-discharge
suicidality. Results will be available in 2022.
Discussion
This protocol describes the first co-produced EMA study to examine the relationship
between sleep and suicidality, and to apply the IMV model in young patients transitioning
from psychiatric hospital to community. We expect our findings will inform co-production in
suicidology research, and clarify the role of digital monitoring of suicidality and/or sleep
before and after initial hospital discharge.
Patients are at high risk of suicidal behaviour and death by suicide immediately following
discharge from an inpatient psychiatric hospital. Furthermore, there is a high prevalence of
sleep problems in inpatient settings which is associated with worse outcomes following
hospitalisation. However, it is unknown whether poor sleep is associated with suicidality
following initial hospital discharge.
Objective:
Our study objective is to describe the ecological momentary assessment (EMA) study
protocol that aims to examine the relationship between sleep and suicidality in discharged
patients.
Methods:
Our study will use EMA design using a wearable device to examine the sleep-suicide
relationship during the transition from acute inpatient care to the community. Prospectively
discharged inpatients aged 18-35 with a mental disorder (n=50) will be assessed for
eligibility and recruited across two sites. Data on suicidal ideation, behaviour and imagery,
non-suicidal self-harm and imagery, defeat, entrapment, and hopelessness, affect and sleep
will be collected on the Pro-Diary V wrist-worn electronic watch for up to 14 days. Objective
sleep and daytime activity will be measured using the inbuilt MotionWare software.
Questionnaires will be administered face-to-face at baseline and follow-up while data will
also be collected on the acceptability and feasibility of using the Pro-Diary V watch to
monitor the transition following discharge. The study has been, and will continue to be, coproduced with young people with experience of being in an inpatient setting and suicidality.
Results:
South Birmingham Research Ethics Committee (Ref: 21/WM/0128) approved the study on
June 28th 2021. We expect to see a relationship between poor sleep and post-discharge
suicidality. Results will be available in 2022.
Discussion
This protocol describes the first co-produced EMA study to examine the relationship
between sleep and suicidality, and to apply the IMV model in young patients transitioning
from psychiatric hospital to community. We expect our findings will inform co-production in
suicidology research, and clarify the role of digital monitoring of suicidality and/or sleep
before and after initial hospital discharge.
Date Issued
2022-05
Date Acceptance
2022-04-22
Citation
JMIR Research Protocols, 2022, 11 (5), pp.1-12
ISSN
1929-0748
Publisher
JMIR Publications
Start Page
1
End Page
12
Journal / Book Title
JMIR Research Protocols
Volume
11
Issue
5
Copyright Statement
©Lindsay H Dewa, Sofia Pappa, Talya Greene, James Cooke, Lizzie Mitchell, Molly Hadley, Martina Di Simplicio, Thomas
Woodcock, Paul Aylin. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 17.05.2022. This
is an open-access article distributed under the terms of the Creative Commons Attribution License
(https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium,
provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information,
a link to the original publication on https://www.researchprotocols.org, as well as this copyright and license information must be
included.
Woodcock, Paul Aylin. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 17.05.2022. This
is an open-access article distributed under the terms of the Creative Commons Attribution License
(https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium,
provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information,
a link to the original publication on https://www.researchprotocols.org, as well as this copyright and license information must be
included.
License URL
Identifier
https://www.researchprotocols.org/2022/5/e33817
Subjects
1103 Clinical Sciences
1117 Public Health and Health Services
Publication Status
Published
Date Publish Online
2022-05-17