Asking Adolescents about Sleep may Help Identify Suicide Risk

Wong, M. M., Brower, K. J., & Zucker, R. A. (in press). Sleep problems, suicidal ideation, and self-harm behaviors in adolescence. Journal of Psychiatric Research

Young people who have trouble sleeping at 12-14 years of age are twice as likely to have suicidal thoughts and four times as likely to deliberately harm themselves or attempt suicide at ages 15-17 as are their peers who do not have trouble sleeping, according to a study appearing in Journal of Psychiatric Research. The authors recommend that parents and health care providers should be alert for signs that teens have trouble sleeping, since this may indicate they may be at risk for suicide. They suggested that teens might be more willing to talk to health care providers or parents about whether they have trouble sleeping than about other problems associated with suicide, such as depression or sexual abuse. Although the research was conducted using data from a project investigating the development of alcoholism and substance abuse in families, trouble sleeping was associated with future suicide risk even when the data analysis was controlled for risk factors such as parental alcoholism or suicidality, depression, self-harm, suicide attempts, overtiredness or nightmares, and demographic variables. This suggests that asking children about whether they are having trouble sleeping may be valuable for assessing suicide risk among young people regardless of the presence or absence of other commonly used indicators of suicide risk. The ability to use “trouble sleeping” as an independent marker of suicide risk is important for two reasons. 1) A significant proportion of young people who become suicidal do not display problems associated with suicide risk, such as depression or previous suicide attempts. Assessments based solely on these risk factors may miss some young people in danger of suicide. 2) The majority of young people with risk factors associated with suicide, such as depression and substance abuse, do not attempt suicide. Asking if a teen if he or she is having trouble sleeping may help a clinician better assess the suicide risk of young people who are depressed, are abusing substances, or have attempted suicide. Readers should note that the study considered sleep disorders as a marker for suicide risk, but not a cause of suicide risk. The research was based on data collected for the Michigan Longitudinal Study. It used a sample of 392 adolescents, 75 percent of whom had at least one parent with alcoholism (although the data analysis was controlled for parental alcoholism).

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