Insufficient sleep and suicidal ideation: a survey of 12,046 female adolescents

Objectives: Adolescence is a period of adaptation to social, hormonal, and physical changes. Because of these changes, adolescents are at risk for depression and suicidal thoughts. Female adolescents tend to be more sensitive to hormonal and emotional changes. Although the reciprocal relationship among depression, poor sleep quality, and suicide has been studied, whether decreased sleep time leads to depression-mediated suicide or induces suicide itself remains to be determined. Therefore, this study aimed to analyze (using a path analysis) the indirect (i.e., due to depression) and direct effects of sleep on suicidal ideation for female adolescents.

Methods: We use nationally representative data from the Korean juvenile health behavior online survey to analyze the sleep effects on suicidal ideation. A total of 12,046 Korean female adolescents were included in this study. We analyzed data from the juvenile health behavior online survey (2017) conducted by the Korea Centers for Disease Control and Prevention and identified variables that could affect the mental health of female adolescents. A path analysis was performed to determine the direct role of sleep in suicidal ideation.

Results: Decreased sleep was one of the several risk factors for suicidal ideation. Unexpectedly, after controlling for other risk factors including depression and socioeconomic factors, insufficient sleep was found to have direct effects on suicidal ideation. The indirect effect of insufficient sleep on suicidal ideation was mediated by depression.

Conclusion: Sleep is a modifiable factor that could reduce the suicide rate among female adolescents and could be targeted through public health prevention efforts.