{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T19:14:13Z","timestamp":1784574853144,"version":"3.55.0"},"reference-count":81,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100003710","name":"Korea Health Industry Development Institute","doi-asserted-by":"crossref","award":["Grant No. HI21C0852"],"award-info":[{"award-number":["Grant No. HI21C0852"]}],"id":[{"id":"10.13039\/501100003710","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Geriatr Psychiatry Neurol"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From August 2021 to December 2023, 243 participants from South Korea were enrolled in a prospective case-control study at a Veterans\u2019 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      69 participants (32.2%) had an Insomnia Severity Index score &gt;15, forming the COMISA group. Suicidal ideation was more prevalent in the COMISA group (43.1% vs 23.4%,\n                      <jats:italic>P<\/jats:italic>\n                      = 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).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08919887251338262","type":"journal-article","created":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T02:49:48Z","timestamp":1750819788000},"page":"444-456","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Evaluating Suicidal Ideation and Anhedonic Symptoms in Obstructive Sleep Apnea Patients with Insomnia"],"prefix":"10.1177","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8404-8006","authenticated-orcid":false,"given":"Hayun","family":"Choi","sequence":"first","affiliation":[{"name":"Brain and Cognition Discovery Foundation, Toronto, ON, Canada"},{"name":"Department of Psychiatry, University of Toronto, Toronto, ON, Canada"},{"name":"Department of Psychiatry, Veteran Health Service Medical Center, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gia Han","family":"Le","sequence":"additional","affiliation":[{"name":"Brain and Cognition Discovery Foundation, Toronto, ON, Canada"},{"name":"Institute of Medical Science, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayla M.","family":"Teopiz","sequence":"additional","affiliation":[{"name":"Brain and Cognition Discovery Foundation, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo B.","family":"Mansur","sequence":"additional","affiliation":[{"name":"Brain and Cognition Discovery Foundation, Toronto, ON, Canada"},{"name":"Department of Psychiatry, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua D.","family":"Rosenblat","sequence":"additional","affiliation":[{"name":"Brain and Cognition Discovery Foundation, Toronto, ON, Canada"},{"name":"Department of Psychiatry, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Wong","sequence":"additional","affiliation":[{"name":"Brain and Cognition Discovery Foundation, Toronto, ON, Canada"},{"name":"Department of Pharmacology &amp; Toxicology, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seonjeong","family":"Byun","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Uijeongbu St Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger S.","family":"McIntyre","sequence":"additional","affiliation":[{"name":"Brain and Cognition Discovery Foundation, Toronto, ON, Canada"},{"name":"Department of Psychiatry, University of Toronto, Toronto, ON, Canada"},{"name":"Institute of Medical Science, University of Toronto, Toronto, ON, Canada"},{"name":"Department of Pharmacology &amp; Toxicology, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,5,8]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2018.05.006"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/jgf2.27"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleepe.2024.100088"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.181.4102.856"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.30773\/pi.2020.0146"},{"key":"e_1_3_4_7_2","volume-title":"International Classification of Sleep Disorders","author":"American Academy of Sleep Medicine","year":"2014","unstructured":"American Academy of Sleep Medicine. 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