What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Suicide ideation and behavior (n=103525). Intervention: Short sleep duration (<8 hours per night) vs. Long sleep duration (≥8 hours per night). Primary outcome: Suicide ideation/consideration (OR 1.92, 95% CI 1.65, 2.23).

August 31, 2023Open Access

Sleep deprivation and suicide risk among minoritized US adolescents

VJVictoria A. JosephColumbia University NKNoah T. KreskiColumbia University KKKatherine M. KeyesColumbia University

Key Result

Short sleep duration (<8 hours) was associated with nearly twice the odds of suicide ideation (OR 1.92) compared to sleeping 8 or more hours among US adolescents.

Study Design

Type

Cross-Sectional (n=103,525)

Structured PICO

Does short sleep duration increase suicide ideation and behavior in US adolescents?

Population

103,525 US high school students from the 2007-2019 Youth Risk Behavior Surveillance System were analyzed to assess the association between sleep duration and suicidal ideation/behavior.

Exposure

Short sleep duration (<8 hours per night)

Comparator

Long sleep duration (≥8 hours per night)

Outcome

Suicide ideation/considerationpatient reported

Short sleep duration is significantly associated with increased odds of suicidal ideation and behavior among US adolescents, with the magnitude of association varying by race/ethnicity.

Main Result

Odds Ratio: 1.92 (95% CI 1.65–2.23)

Limitations

Questionnaires before 2007 did not include questions on sleep duration
Use of a 4-level race/ethnicity variable combined several groups into one overarching category, limiting subgroup analysis
Wide confidence intervals indicate statistical power may have been compromised for some groups
Responder bias due to self-reported survey data
Family socioeconomic status was not included as a covariate
Adolescents not enrolled in high schools were not included in the sample

Abstract

Abstract Objectives To assess (1) the prevalence of suicide ideation/behavior among adolescents with short sleep by race/ethnicity and (2) the association between sleep duration and suicidal ideation and behavior among American youth by race/ethnicity from 2007 to 2019. Methods Data were drawn from the Youth Risk Behavior Surveillance System (YRBSS). Logistic regression analyses were used to assess the relationship between sleep duration and suicidal ideation/behavior. Results Overall, suicide ideation/behavior increased among U.S. adolescents of all racial groups from 2007 to 2019. Adjusting for race/ethnicity, sexual identity, age, sex, substance use, trauma, and bullying, those with short sleep had approximately twice the odds OR: 1.92 (95% CI: 1.65, 2.23) of suicide ideation/consideration compared to those with long sleep. Stratified analyses indicated that Black students with short sleep had higher odds of making a suicide plan (OR = 1.51, 95% C.I.: 1.27, 1.79) compared with Black students with long sleep. A similar pattern was observed across other racial/ethnic groups (e.g., Hispanic: (OR = 1.74, 95% C.I.: 1.53, 1.97). Conclusion Emphasis on suicide interventions is of the essence, especially with increasing rates. Sleep duration significantly predicts suicide risk among all adolescents. Additional research is needed to assess factors that predict suicide among minoritized adolescents, specifically Black and Hispanic adolescents.

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