Abstract Introduction Sleep variables are consistently linked to mental health outcomes, yet few studies have examined how specific sleep factors predict suicidality in adolescents. Adolescence is a critical development period that involves physical, social, and psychological changes that can influence sleep, making this population vulnerable to sleep-related mental health issues. We aimed to see how specific sleep health variables including sleep quality, duration, efficiency, chronotype, and daytime sleepiness predict suicidality in adolescents. Methods Participants included 55 adolescents (ages 14-18, M=15.8) who completed the Morning-Eveningness Questionnaire (MEQ) to assess chronotype, the Epworth sleepiness Scale (ESS) to measure daytime sleepiness, and the Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep quality. Suicidality was coded as 1 if the participant’s responses endorsed suicidal intent or desire and 0 if their response did not. A logistic regression analysis was used to evaluate the predictive effect of sleep quality, duration, efficiency, daytime sleepiness, and chronotype on adolescent suicidality. Results Our logistic regression model was significant, χ²(5)=18.53, p=.002, pseudo R²=.28. Correlations among predictors were small (all r.10), indicating no multicollinearity. Sleep quality was the only significant predictor of suicidality, such that higher PSQI scores were associated with greater odds of suicidality (OR=1.56, p=.003). Sleep duration approached significance (p=.058). The remaining predictors (daytime sleepiness (OR=0.89, p=.169), chronotype (OR=1.05, p=.308), and sleep efficiency (OR=0.91, p=.243) were not significantly related to suicidality. Conclusion Our findings suggest that sleep quality is the most meaningful predictor of suicidal intent/desire among adolescents, even when accounting for other sleep parameters. Identifying and addressing poor sleep quality may be a critical component of suicide-risk evaluation and treatment. Clinicians working with adolescents with suicidality may consider integrating evidence-based sleep interventions as a complementary pathway for reducing suicide risk. Support (if any)
Stevens et al. (2026) studied this question.