biostudies-literatureKalmbach DANHLBI NIH HHSAmerican Academy of Sleep MedicineNational Heart Lung and Blood Institute439-442https://www.ebi.ac.uk/biostudies/studies/S-EPMC8142329biostudies-literatureUnknown81<h4>Objectives</h4>This prospective study explored associations among insomnia, nocturnal cognitive hyperarousal, and nocturnal perinatal-focused rumination with suicidal ideation (SI) in perinatal women with depression.<h4>Methods</h4>From late pregnancy through early postpartum, 39 depressed women completed 17 weekly surveys assessing SI, insomnia, depression, stress, and cognitive arousal.<h4>Results</h4>Women with nocturnal cognitive hyperarousal at baseline, relative to those with low cognitive arousal, were at greater risk for new onset SI (33% vs 1%). Moreover, nocturnal perinatal-focused rumination was independently associated with SI. SI-risk was highest when women reported clinical insomnia combined with nocturnal cognitive hyperarousal (OR = 5.66, p = 0.037) or perinatal-focusedSleep medicineNocturnal cognitive hyperarousal, perinatal-focused rumination, and insomnia are associated with suicidal ideation in perinatal women with mild to moderate depression.PMC8142329K23 HL138166Gelaye BDrake CLCheng PAhmedani BKKalmbach DAfalseNocturnal cognitive hyperarousal, perinatal-focused rumination, and insomnia are associated with suicidal ideation in perinatal women with mild to moderate depression.<h4>Objectives</h4>This prospective study explored associations among insomnia, nocturnal cognitive hyperarousal, and nocturnal perinatal-focused rumination with suicidal ideation (SI) in perinatal women with depression.<h4>Methods</h4>From late pregnancy through early postpartum, 39 depressed women completed 17 weekly surveys assessing SI, insomnia, depression, stress, and cognitive arousal.<h4>Results</h4>Women with nocturnal cognitive hyperarousal at baseline, relative to those with low cognitive arousal, were at greater risk for new onset SI (33% vs 1%). Moreover, nocturnal perinatal-focused rumination was independently associated with SI. SI-risk was highest when women reported clinical insomnia combined with nocturnal cognitive hyperarousal (OR = 5.66, p = 0.037) or perinatal-focused2021-01-01T00:00:00Z2021 May2025-04-05T10:03:19.055Z2025-04-05T10:03:19.055ZS-EPMC81423293383937310.1016/j.sleep.2021.03.004