Citation

Liu JW, Tu YK, Lai YF, Lee HC, Tsai PS, Chen TJ, Huang HC, Chen YT, Chiu HY. Sleep 2019; 42(6): ePub.

Affiliation

Research Center of Sleep Medicine, School of Medicine, Taipei Medical University.

Copyright

(Copyright © 2019, American Academy of Sleep Medicine, Publisher Associated Professional Sleep Societies)

DOI

10.1093/sleep/zsz054

PMID

30843072

Abstract

STUDY OBJECTIVES: To systematically review and meta-analyze the associations between sleep disturbances and suicidal ideation, plans, and attempts in adolescents and explore potential moderators of these associations.

METHODS: Embase, PubMed, ProQuest, and the China Knowledge Resource Integrated Database were searched from their inception dates to October 19, 2018. We selected cross-sectional, prospective, or retrospective studies without time or language restrictions.

RESULTS: Nine cross-sectional studies, 4 prospective studies, and one retrospective report that respectively involved 37 536, 9295, and 80 adolescents were included in the meta-analysis. Cross-sectional analyses revealed that adolescents with sleep disturbances were at higher risks of suicidal ideation, plans, and attempts (pooled odds ratios [ORs] = 2.35, 1.58, and 1.92) than those without sleep disturbances. Prospective reports indicated that sleep disturbances in adolescents significantly predicted the risk of suicidal ideation but not suicide attempts (pooled ORs = 1.79 and 1.98, 95% confidence intervals = 1.36-2.36 and 0.62-6.29, respectively). The retrospective study did not support the association between sleep disturbances and suicide attempts. Depression did not moderate the associations between sleep disturbances and suicidal ideation or attempts in adolescents. Adolescents with insomnia complaints had a higher risk of suicidal ideation than those with other sleep complaints. Age, the female percentage, and reliable sleep measures were significant moderators (all P <.05).

CONCLUSION: Sleep disturbances, particularly insomnia, should be considered an influencing factor when developing preventive strategies against adolescent suicidal ideation. Additional prospective studies are warranted to establish causality of sleep disturbances in youth suicide plans and attempts.

© Sleep Research Society 2019. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Language: en

Keywords

Sleep disturbances; adolescents; meta-analysis; suicidality