Coping-Strategies as a Mediator Between Symptoms of Sleeping Problems and Risk of Suicide

Abstract

Background: Suicide is a complex, global phenomenon linked to various intersecting vulnerability factors. Among these, sleep-related symptoms represent a significant yet understudied contributor to suicide risk. This study explored whether the concurrent relationship between sleep-related symptoms and suicide risk is statistically mediated by distinct coping strategies within an exploratory cross-sectional framework, addressing data non-normality through robust analytical methods.

Methods: A total of 1014 participants (33.83% male, 66.17% female) aged 18 to 75 years (M = 33.00, SD = 15.15) participated in an online survey distributed through snowball recruitment. Participants completed the amplified Sleep Symptom Subscale (Su-a) of the Brief Symptom Checklist (LSB-50), the Coping with Stress Questionnaire (CSQ), and the Risk of Suicide Scale (RS). Multiple mediation analyses were conducted to evaluate the indirect effects of coping dimensions while adjusting for sex, age, educational attainment, and socioeconomic status.

Results: Sleep-related symptoms were positively associated with suicide risk. Negative self-focus emerged as the strongest mediator (β = 0.112, 95% CI [0.083, 0.143]), whereas Positive Reappraisal (β = 0.018, 95% CI [0.007, 0.032]) and Seeking Social Support (β = 0.012, 95% CI [0.001, 0.024]) acted as protective mediators. Overt emotional expression also showed a small but significant indirect effect (β = 0.009, 95% CI [0.001, 0.018]). A significant direct effect of sleep-related symptoms on suicide risk remained, indicating partial mediation. 

Conclusions: The findings suggest that coping processes contribute to the connection between sleep difficulties and suicide risk. Interventions aimed at reducing maladaptive coping and strengthening adaptive coping skills may help diminish suicidal vulnerability among individuals experiencing sleep disturbances.