Sleep Duration as a Predictor of Suicidal Ideation Among High-Risk Adolescents

Abstract

Abstract Background: Suicide is the second leading cause of death among youth aged 15 to 24, highlighting the need for improved prediction methods for the assessment of suicidal risk. Identifying modifiable risk factors relevant to adolescents is crucial for suicide prevention. Sleep patterns have been linked to suicidality in adults but lack sufficient study in youth. Objectives: This prospective study aimed to explore the relationship between objectively- and subjectively-measured sleep characteristics and next-day suicidal ideation in at-risk youth. Methods: Thirty-three adolescents (12-18 years old) admitted to the psychiatric ward post-suicide attempt or due to suicidal intent within the previous month were included. Objective (actigraphy) and subjective (sleep diary) assessments of sleep patterns were conducted for ten consecutive days. Daily suicidal ideation was evaluated through a questionnaire based on the validated C-SSRS interview. Results: A negative association was observed between total sleep time and expressing a "death wish" the following day. Each one-hour decrease in objectively measured total sleep time increased the odds of a death wish by 40% (Z=-2.55, p=0.011, CI -0.34 [-0.61, -0.08]). Even after adjusting for sedative medication use and self-reported depression severity, a loss of approximately two hours of sleep predicted a two-fold increase in expressing a death wish the next day. Conclusions: Our study highlights the interplay between sleep patterns and suicidal ideation, with sleep duration playing a significant role. Short sleep duration increases the likelihood of experiencing suicidal ideation the following day among high-risk youth.