0813 Sleep Duration Moderates the Association Between Bullying and Suicide Attempts Among U.S. Adolescents

Abstract Introduction Suicide is a major public health issue among adolescents in the United States, with rates having more than doubled over the past 15 years. Bullying is a significant risk factor for suicide attempts during adolescence, while sleep insufficiency is concurrently associated with both bullying and suicide attempts. Although joint presence of these exposures may interact to predict suicide attempts, research has not sufficiently investigated whether sleep duration might moderate the association between bullying and suicide attempts. Methods This study draws upon data from the 2021 Youth Risk Behavior Surveillance System, comprising a nationally representative sample of 17,134 participants. Multivariable logistic regression was used to evaluate the relationships among bullying (school/electronic), sleep duration, and past-year suicide attempts among adolescents aged 12-18. Covariates included sex, age, race/ethnicity, screen time, and poor mental health. All analyses accounted for complex survey sampling used by the YRBSS. Results 15% and 16% of adolescents were bullied at school or electronically, respectively; 10.2% had made ≥ 1 suicide attempt during the past year; 77.3% did not adhere to sleep duration recommendations; and 29.3% reported poor mental health either “most of the time” or “always”. In adjusted models, adolescents who were bullied in school or electronically were three times as likely to attempt suicide vs. those who were not bullied (odds ratio (OR): 3.0, 95% CI:2.4; 3.7. Adolescents with ≤4 hours of sleep (10.7%) were twice (OR: 2.6, 95% CI:1.5; 3.0) as likely to attempt suicide. Sleep duration significantly moderated the association between bullying in schools and suicide attempts (F5,44=3.1;p=0.019), with those who were bullied showing a higher likelihood of suicide attempts with lower (≤4-6 h) or higher (8-10+h) sleep duration. Those reporting no bullying showed reduced likelihood of suicide attempts as sleep duration increased to 7 hours, and the likelihood remained constant with more hours of sleep. Sleep duration did not moderate this association for electronic bullying. Conclusion Bullying (school/electronic) and short sleep duration significantly increase the odds of reported suicide attempts in teenagers. Future research is needed to elucidate why sleep moderates suicide attempts differently among adolescents who are bullied vs. those who are not. Support (if any) COBRE Award Number P20GM139743