Sleep and adolescent suicidal behavior

Sleep. 2004 Nov 1;27(7):1351-8. doi: 10.1093/sleep/27.7.1351.


Study objectives: Suicide risk begins to increase during adolescence. Adolescents do not get enough sleep and are also at risk for many sleep disturbances. This study examined the association between sleep patterns and sleep problems and adolescent suicidal behavior.

Design and setting: A questionnaire survey of adolescents attending school was conducted in one prefecture of Shandong Province, People's Republic of China.

Participants: A total of 1,362 adolescents attending school (mean age 14.6 years, 60% males) participated in the survey.

Measurements: Respondents completed a self-administered questionnaire that asked about sleep patterns, sleep problems, suicidal behavior, depressive symptoms, and demographic characteristics of the family and adolescent.

Results: Overall, 19.3% of the sample reported having suicidal ideation, 10.5% having suicide attempts in the past 6 months, 16.9% having insomnia symptoms, 2.3% having taken hypnotic medication, and 48.9% having experience of nightmares in the past month. Mean night sleep duration was 7.6 hours (SD = 0.8). Logistic regression analyses showed that sleeping less than 8 hours at night (OR = 2.89, 95% confidence interval [CI] = 1.07-7.81) and frequent nightmares (OR = 2.43, 95% CI = 1.76-3.35) were significantly associated with increased risk for suicide attempts after adjustment for age, sex, father's occupation, and depressive symptoms and that nightmares (OR = 1.69, 95% CI = 1.20-2.38) were also significantly related to suicidal ideation.

Conclusion: These findings demonstrate the association between short sleep duration and nightmares and suicidal behavior and highlight the potential role of sleep intervention in the prevention of adolescent suicide.

MeSH terms

  • Adolescent
  • Causality
  • China
  • Cross-Sectional Studies
  • Depression / diagnosis
  • Depression / epidemiology
  • Depression / psychology
  • Dreams / psychology
  • Female
  • Health Surveys
  • Humans
  • Male
  • Rural Population / statistics & numerical data*
  • Sleep Deprivation / diagnosis
  • Sleep Deprivation / epidemiology*
  • Sleep Deprivation / psychology
  • Sleep Initiation and Maintenance Disorders / diagnosis
  • Sleep Initiation and Maintenance Disorders / epidemiology*
  • Sleep Initiation and Maintenance Disorders / psychology
  • Statistics as Topic
  • Suicide, Attempted / psychology
  • Suicide, Attempted / statistics & numerical data*
  • Surveys and Questionnaires