Abstract
There are few studies examining which types of sleep problems are independently associated with suicide attempt (SA) and gender difference in adolescents. The aim of the present study was to examine whether specific sleep problems were uniquely associated with suicide attempt in adolescents and explore gender differences in the association. A school-based health survey was conducted in four provinces within China from November 2014 to January 2015. A total of 15,132 students aged 10–21 years completed standard questionnaires assessing past 12 month suicide attempt in addition to measures of sleep quality, quantity and sleep beliefs. 5.4% of participants reported a suicide attempt within the last 12 months. After adjustment for sociodemographic variables and psychological symptoms, almost all sleep problems remained significantly associated with a greater endorsement of suicide attempt. Further adjustment for co-occurring sleep problems revealed that weekday sleep duration (<6, 8–10, and ≥10 h), insomnia (often), and nightmares (sometimes and often) remained independently associated with suicide attempt in boys (p < 0.05). However in girls, weekday sleep duration (<6 and ≥10 h), weekend sleep duration (<6 h), midday nap (0 or 1–2 d/week), insomnia (sometimes and often), nightmare (often) and sleep beliefs (high) were independently associated with suicide attempt (p < 0.05). Multiple sleep problems are associated with suicide attempt in adolescents, however the relationship varies by gender.
Highlights
As the second leading cause of death in young people worldwide [1], adolescent suicide continues to exact a substantial economic, social and psychological burden for individuals, families, and communities globally
The present study used data from a large-school survey conducted in China to investigate whether specific sleep problems were uniquely associated with suicide attempt (SA) and whether the relationship varied by gender
Our analysis suggests that various sleep problems are associated with suicide attempt in adolescents with extended weekday sleep durations and frequent nightmares shown to be among the strongest risk factors
Summary
As the second leading cause of death in young people worldwide [1], adolescent suicide continues to exact a substantial economic, social and psychological burden for individuals, families, and communities globally. Whilst progress has been made in our understanding of the phenomenology and risk factors associated with adolescent suicidality, less is known about the role of sleep in suicidal behavior. This is despite sleep problems being linked to a myriad of other psychosocial and general health complications in adolescent populations [2]. Students who reported sleeping 9 h/day (AOR = 2.67) exhibited an increased likelihood of suicide attempt [8]
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