Suicide is a critical public health concern among adolescents. Although sleep duration links to suicidal behaviors in children and adolescents, relevant research is insufficient in China. This study sought to explore the association between sleep duration and suicidal behaviors among Chinese adolescents. Data were obtained from the baseline survey of Zhejiang Childhood Behavior and Health Cohort, including 12,779 middle and high school students aged 11–19 years. Information on sleep duration, suicidal behaviors (ideation, plans, attempts), sociodemographic variables, health behaviors, mental health-related behaviors, and other sleep-related characteristics was collected via an anonymous self-administered questionnaire. Insufficient, optimal, and excessive sleep duration were defined according to the American Academy of Sleep Medicine guidelines, with cutoffs of 12 h / day for 6–12 year-olds and 10 h/day for adolescents aged ≥ 13 years. Multivariable logistic regression models were applied to estimate adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) for the associations between sleep duration categories and suicidal behaviors. Additionally, subgroup and sensitivity analyses were also performed. The mean (SD) age of participants was 13.5 (1.4) years. In the past 12 months, the self-report rates of suicidal ideation, plans, and attempts were 18.2%, 8.8%, and 5.2%, respectively. After adjusting for potential confounders, insufficient sleep was associated with suicidal ideation, plans and attempts in adolescents (vs. optimal sleep), with OR of 1.32 (95% CI: 1.18–1.48), 1.22 (95% CI: 1.05–1.41) and 1.32 (95% CI: 1.09–1.58), respectively. Sensitivity analyses supported the robustness of the results. In this cross-sectional study, insufficient sleep was found to be associated with suicidal behaviors among Chinese adolescents, whereas no significant association was observed for excessive sleep.
Xu et al. (2026) studied this question.