Researchers have found that high-level sleep disturbances in preteens tend to increase the odds of suicidal thoughts and behaviors in later life. A cohort study involving more than 8,000 children found that when children are reported to experience sleep problems at the age of 10, for example, that is the same age where those children were found to be more likely to report suicidal ideation or attempt. This study conducted by Joel Stoddard, MD, and his colleagues at the Children's Hospital Colorado and University of Colorado Anschutz Medical Campus points out the necessity for checking sleep as a potential risk factor for early intervention and suicide prevention. The study was published in JAMA Network Open.
The cohort consisted of 10,136 children with no previous suicidal thoughts or attempts at baseline, recruited within the Adolescent Brain Cognitive Development Study. Data collection began June 2016 through January 2021. The study aimed to determine whether sleep disturbances were associated with subsequent suicidal behavior. Sleep data were collected using the Sleep Disturbance Scale for Children, a 26-item parent report inventory. Other covariates controlled in the study were anxiety, depression, family history of mental health disorders, family conflict, and parental monitoring. The Kiddie Schedule for Affective Disorders and Schizophrenia was administered on follow-up at 2 years.
Results
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Severe sleep disturbances at age 10 had greater odds of reporting suicidal ideation or attempts by age 12, with the odds being 2.68 times at 95% CI 1.44-4.98, P=0.002).
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The association between daily nightmares was the strongest. Children who had daily nightmares had a five times higher risk of suicidal behavior 2 years later (95% CI 1.42-21.04, P=0.01) as compared to those who did not have nightmares.
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At 2-year follow-up, 91.3% of the sample gave no evidence of suicidal behavior, while passive suicidal ideation was reported by 3.6%, nonspecific suicidal ideation by 2.9%, specific suicidal ideation by 1.5%, and attempted suicide for the first time was reported by 0.7%.
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Even after controls were established for depression, anxiety, family conflict, and aspects of parental monitoring, sleep problems continued to be associated with a higher risk for suicide attempts and ideation during early adolescence.
This study had several limitations, one of which is that the data on both sleep disturbances and suicidal behavior were self-reported by both parents and their children. The study did not use objective measures of sleep, like polysomnography. This forms another point of weakness because the sample under study was a homogeneous population, and most of these families belong to higher socio-economic strata. According to the authors, parents would not understand or report their child's innermost thoughts and feelings, especially those concerning suicidal thoughts.
This study gives considerable evidence that severe sleep disturbances among preteens are associated with a considerably heightened risk of suicidal thoughts and behavior by early adolescence. Routine nightmares, inability to fall asleep, and disrupted sleep patterns should be taken as early warning signs of a potential mental health crisis. Since the case of sleep disturbances is visible and treatable, it is encouraged that healthcare providers and parents pay significant attention to this as a preventive measure to mitigate the risk of youth suicide.
Reference:
Gowin, J. L., Stoddard, J., Doykos, T. K., Sammel, M. D., & Bernert, R. A. (2024). Sleep disturbance and subsequent suicidal behaviors in preadolescence. JAMA Network Open, 7(9), e2433734–e2433734. https://doi.org/10.1001/jamanetworkopen.2024.33734
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