Abstract: Background　Sleep disturbances are the most prominent and common problem in patients with mental disorders.Some studies have indicated that sleep disturbances may increase the risk of suicide.However，the results of those studies were inconsistent and controversial.Therefore，it is necessary to determine the relationship between sleep disturbances and suicide in patients with mental disorders.Objective　To assess the association between sleep disturbances and suicide in patients with mental disorders by meta-analysis.Methods　PubMed，EMBase，Cochrane Library，Ovid，EBSCO，CNKI，Wanfang Data，VIP and SinoMed were searched for studies about sleep disturbances and suicide in mental disorders patients from inception to April 1，2019.Two researchers independently screened studies according to the inclusion and exclusion criteria，extracted data，and assessed the quality.Meta-analysis was conducted by using Stata 15.1.Results　A total of 21 studies were included，including 17 cross-sectional studies and 4 cohort studies，with a total of 8 118 patients.Meta-analysis showed that sleep disturbances were associated with an increased relative risk of overall suicide either confounding factors were adjusted 〔OR=2.22，95%CI（1.98，2.49），P<0.001〕or not 〔OR=2.17，95%CI（1.92，2.44），P<0.001〕.Subgroup analysis showed that either confounding factors were adjusted or not，general sleep disturbances，nightmares，other sleep problems were associated with an increased relative risk of developing different suicide types（all suicide types，suicidal ideation，attempted suicide，and other types of suicide）（P<0.05），and insomnia was associated with an increased relative risk of all suicide types，suicidal ideation，and attempted suicide（P<0.05）.Meta-analysis showed that after correcting depression symptoms，sleep disturbances were associated with an increased relative risk of overall suicide 〔OR=1.69，95%CI（1.33，2.15），P<0.001〕.Conclusion　Sleep disturbances are associated with suicide in patients with mental disorders.

Key words: Mental disorders, Dyssomnias, Suicide, Meta-analysis

摘要： 背景　睡眠紊乱是精神障碍患者最突出和普遍的问题，部分研究指出睡眠紊乱可能会增加精神障碍患者的自杀风险，然而这些研究结果尚存在争议，因此确定精神障碍患者睡眠紊乱与自杀的关系十分必要。目的　运用Meta分析方法评价精神障碍患者睡眠紊乱与自杀的关系。方法　计算机检索PubMed、EMBase、Cochrane Library、Ovid、EBSCO、中国知网、万方数据知识服务平台、维普网引文数据库、中国生物医学文献服务系统等数据库，检索时限为建库至2019-04-01。收集相关文献，由两名研究人员独立筛选文献、提取资料并评价纳入文献质量后，采用Stata 15.1软件进行Meta分析。结果　共纳入21项研究，其中17项横断面研究、4项队列研究，共8 118例患者。Meta分析结果显示，未矫正与矫正混杂因素后，精神障碍患者睡眠紊乱与总体自杀的相对风险增加均相关〔OR=2.22，95%CI（1.98，2.49），P<0.001；OR=2.17，95%CI（1.92，2.44），P<0.001〕。亚组分析结果显示，未矫正与矫正混杂因素后，总体睡眠紊乱、噩梦、其他睡眠问题与总体自杀、自杀意念、自杀未遂和其他自杀类型的相对风险增加均相关（P<0.05）；失眠与总体自杀、自杀意念和自杀未遂的相对风险增加均相关（P<0.05）。矫正抑郁症状后，Meta分析结果显示，精神障碍患者睡眠紊乱与自杀的相对风险增加相关〔OR=1.69，95%CI（1.33，2.15），P<0.001〕。结论　精神障碍患者睡眠紊乱可以增加其自杀风险。

关键词: 精神障碍, 睡眠异常, 自杀, Meta分析