Evaluating Suicidal Ideation and Anhedonic Symptoms in Obstructive Sleep Apnea Patients with Insomnia
Bibliographic record
Abstract
Objective Insomnia and obstructive sleep apnea (OSA) are prevalent in the geriatric population, with co-morbid insomnia and sleep apnea (COMISA) increasing the risk of suicidal ideation. Anhedonia, a core depression feature, is associated with suicidal ideation. This study aimed to explore the relationship between COMISA and suicidality including the mediating effect of anhedonic symptoms. Methods From August 2021 to December 2023, 243 participants from South Korea were enrolled in a prospective case-control study at a Veterans’ hospital. Participants underwent interviews, self-report measures, and polysomnography. 214 untreated OSA participants were categorized into COMISA and OSA-only groups. Anhedonic symptoms and their correlates were investigated. Results 69 participants (32.2%) had an Insomnia Severity Index score >15, forming the COMISA group. Suicidal ideation was more prevalent in the COMISA group (43.1% vs 23.4%, P = 0.007). After adjusting for covariates such as age, gender, body mass index, alcohol and smoking consumption, caffeine intake, hypertension, diabetes mellitus, and sleep-related factors, the odds of suicidal ideation were higher in the COMISA group (OR = 2.42, 95% CI = 1.14 - 5.11). However, after adjusting for anhedonic symptoms, this association was no longer significant. Anhedonic symptoms mediated the relationship between insomnia and suicidal ideation (OR = 1.045, 95% CI = 1.013-1.074). Conclusions The findings of this study underscore the emergence of suicidal ideation among individuals with COMISA. Understanding the mechanisms of anhedonic symptoms underlying the relationship between COMISA and suicidal ideation is crucial for developing targeted interventions to mitigate suicidality in this population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".