January 31, 2011 — Vol. 27 No. 5
Even factoring out depression, sleep problems in youths are the top markers for determining suicidal thoughts and behavior in adolescents, according to a new study by Idaho State University and University of Michigan researchers.
The study could have major implications on how clinicians pursue treatment with youth. The researchers conclude: "parents and primary care physicians are encouraged to be vigilant and screen for sleep problems in young adolescents. Future research should determine if early intervention with sleep disturbances reduces the risk" for suicide and thoughts of suicide in adolescents.
Previous studies have shown that sleep is an important risk factor, but there is the question that if someone is depressed or exposed to other risk factors, does that affect their sleep patterns, according Maria Wong, Idaho State University associate professor of psychology, one of the principal investigators on the study, who teamed up with Professors Kirk Brower and Robert Zucker at the University of Michigan.
"We wondered that if you control for depression, is there still a relationship between sleep deprivation and suicidal thoughts in adolescents," Wong said. "Our study controlled for depression and we still found that not being able to sleep well and a general feeling of tiredness are the two significant predictors to suicidal thoughts and behavior."
Wong was quick to point out that "we don't have proof that one causes the other," but that tiredness and trouble sleeping are good markers of risk factors in youth and suicidal behavior.
"In terms of treatment, this could have some major implications," Wong said. "One of the points we make, in terms of how it affects clinicians, is that it is easier to talk to anybody, including kids, about sleep than it is about depression or suicide. Talking about sleep could be a good place to start talking about more important issues. The study also suggests that early intervention in sleep disturbances might also reduce risk."
The title of the study is "Sleep problems, suicidal ideation, and self-harm behaviors in adolescence." It was published electronically online in October in the Journal of Psychiatric Research and will be published in that journal in 2011.
Study participants were 280 boys and 112 girls from a community sample of high-risk alcoholic families and controls in an ongoing prospective study in Michigan. The researchers controlled for gender, parental alcoholism and parental suicidal thoughts and prior suicidal thoughts or self-harm behaviors when participants were ages 12-14. Trouble sleeping at 12-14 significantly predicted suicidal thoughts and self-harm behaviors at ages 15-17.
"Depressive symptoms, nightmares, aggressive behavior, and substance-related problems at ages 12-14 were not significant predictors when other variables were in the model," according to the study.
These findings are consistent with the findings from earlier studies on adults.
Wong is also involved in a study to replicate the findings of the Michigan study on a much broader scale, using data from the "National Longitudinal Study of Adolescents," a nationally represented sample in the United States. Her study results from a much larger pool of youths on a national scale are mirroring the results of Michigan study.
"Research findings are robust linking sleep problems with suicidal thoughts and actions in adolescents," Wong said. "Future research could focus on identifying factors that may explain the relationship between sleep problems and suicidal behavior."