Relationship Between Sleep Apnea Diagnosis and Suicide Risk in Veterans with Traumatic Brain Injury

Research Objectives: To examine the relationship between obstructive sleep apnea (OSA) and suicide risk in persons with traumatic brain injury (TBI) has received little empirical investigation. We hypothesized that OSA would predict suicide risk following TBI.

Design: Secondary analysis of the TBI Model Systems longitudinal multicenter study.

Setting: Neurorehabilitation units at five Veterans Affairs (VA) Polytrauma Rehabilitation Centers.

Participants: Veterans admitted for TBI rehabilitation who completed a 1 year (N=392), 2-year (N=444), 5-year (N=498), or 10-year follow up (N=252). Lost to follow up rate was 7.8-14.5% depending on follow up year.

Interventions: Not applicable.

Main Outcome Measures: Suicide ideation and suicide attempts.

Results: Post-TBI suicide ideation was predicted by pre-TBI suicide attempts (aOR = 2.81, p = .020), concurrent depression symptom severity (aOR = 1.24, p < .001), and lower concurrent participation (a = .060, p = .037). Post-TBI suicide attempts was predicted by pre-TBI suicide attempts (aOR = 4.53, p = .002), concurrent headache severity (aOR = 1.53, p = .024), and concurrent suicidal ideation (aOR = 3.53, p = .007). Contrary to study hypotheses, OSA diagnosis did not predict either suicidal ideation (p = .191) or suicide attempts (p = .992).

Conclusions: Consistent with prior literature, depression, participation, headache severity, prior suicidal ideation, and prior suicide attempts predicted post-TBI suicide risk. Limitation of this study include self-report method of OSA identification, and lack of information on OSA severity and OSA treatment.

Author(s) Disclosures: This material is the result of work supported with resources and the use of facilities at the James A. Haley Veterans’ Hospital. The views expressed in this presentation are of the authors and do not necessarily represent official policy or position of the Defense Health Agency, Department of Defense, or any other U.S. government agency. This work was prepared under Contract HT0014-22-C-0016 with DHA Contracting Office (CO-NCR) HT0014 and, therefore, is defined as U.S. Government work under Title 17 U.S.C.§101. Per Title 17 U.S.C.§105, copyright protection is not available for any work of the U.S. Government. For more information, please contact dha.TBICOEinfo@health.mil.
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