University of Arkansas for Medical Sciences Department of Psychiatry, Little Rock, AR 72205, USA.
J Clin Sleep Med. 2011 Aug 15;7(4):351-6. doi: 10.5664/JCSM.1188.
Suicide in the adolescent population is a tragic and preventable cause of death. Previous studies have confirmed both long and short total sleep times (TSTs) are associated with suicidal ideation in the adult population. We hypothesized that both long and short TSTs are risk factors for serious suicide attempt in the adolescent population as well.
We tested this hypothesis using the Youth Risk Behavior Surveys from 2007 and 2009, which consist of school-based, nationally representative samples (N = 12,154 for 2007, N = 14,782 for 2009). Logistic regression models were used to assess the relationship between suicidality and sleep after adjusting for confounders including age, sex, race/ethnicity, feelings of sadness, and substance abuse.
Of the total sample, roughly 15% reported suicidal ideation, 10% planned suicide, 5% attempted and 2% reported an attempt requiring treatment. Teens who reported sleeping ≤ 5 or ≥ 10 h had a significantly higher risk for suicidality compared to those with a TST of 8 h. The largest odds ratios were found among the most severe forms of suicidality (attempt requiring treatment) with an odds ratio of 5.9 for a TST ≤ 4 h and 4.7 for a TST ≥ 10 h.
Both short and long TSTs are risk factors for suicidality among teens and extremes in TST may indicate more serious suicidality. Self-reported sleep duration may be a useful screening question for suicide risk. Future studies should examine whether sleep duration is a causal and/or modifiable risk factor for suicidality in teens.
青少年人群中的自杀是一种悲惨且可预防的死亡原因。先前的研究已经证实,总睡眠时间(TST)过长和过短与成年人的自杀意念有关。我们假设,TST 过长和过短也是青少年人群发生严重自杀企图的危险因素。
我们使用 2007 年和 2009 年的青少年风险行为调查来检验这一假设,该调查由基于学校的全国代表性样本组成(2007 年为 12154 人,2009 年为 14782 人)。使用逻辑回归模型评估了在调整了年龄、性别、种族/民族、悲伤感和物质滥用等混杂因素后,自杀意念与睡眠之间的关系。
在总样本中,约 15%的青少年报告有自杀意念,10%的青少年有自杀计划,5%的青少年尝试过自杀,2%的青少年报告需要治疗的自杀企图。与 TST 为 8 小时的青少年相比,报告睡眠时间≤5 小时或≥10 小时的青少年自杀的风险显著更高。在最严重的自杀形式(需要治疗的自杀企图)中,发现了最大的优势比,TST≤4 小时的优势比为 5.9,TST≥10 小时的优势比为 4.7。
TST 过短和过长都是青少年自杀的危险因素,TST 的极端值可能表明更严重的自杀意念。自我报告的睡眠时间可能是自杀风险的一个有用的筛查问题。未来的研究应探讨睡眠时间是否是青少年自杀的一个因果和/或可改变的危险因素。