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. 2024 Dec 24;12(1):777.
doi: 10.1186/s40359-024-02273-9.

The association between insomnia and suicide attempts among Chinese adolescents: a prospective cohort study

Yuanyuan Lu #  1 , Zeteng Liu #  2 , Xuerong Luo  1 , Lintong Song  1 , Tianqing Fan  1 , Chunxiang Huang  3 , Yanmei Shen  4
Affiliations

The association between insomnia and suicide attempts among Chinese adolescents: a prospective cohort study

Yuanyuan Lu et al. BMC Psychol. .

Abstract

Objective: This study aimed to investigate a range of insomnia-related factors, including difficulty with sleep induction, nocturnal awakenings, early awakenings, total sleep time, overall sleep quality, well-being, functioning, and daytime drowsiness, to determine which variables were significantly associated with subsequent adolescent suicide attempts.

Method: A total of 782 students aged 11-16 years old from one middle school in Changsha, China completed the survey at baseline and 6 months follow-up with a prospective cohort design. The binary logistic regression models were used to analyze the associations between insomnia variables and suicide attempts during the 6 months follow-up.

Results: The new incidence rate of suicide attempts was 4.60% (36/782) at 6-month follow-up. Insomnia was a significant predictor of incident suicide attempts (OR = 6.00; 95%CI, 2.47-14.60). After adjusting for age, gender, nationality, stress, anxiety and depression, insomnia was found to predict suicide attempts only among female (OR = 4.28; 95%CI, 1.41-12.98) and only nocturnal sleep disruption was significantly associated with an increased risk of suicide attempts (OR = 2.74; 95%CI, 1.32-5.71).

Conclusions: Nocturnal sleep disruption are independently associated with increased risk of suicide attempts. Intervention for nocturnal sleep disruption may be important for early identification as well as prevention of adolescent suicide, especially among adolescent girls.

Keywords: Adolescents; Cohort study; Insomnia; Suicide attempts.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: All clinical trials described in the manuscript were carried out in accordance with Declaration of Helsinki promulgated by the National Institute of Health. Informed consent for participating in this study was provided to all the students and their guardians. Protocols of this study was approved by the ethics committee of the Second Xiangya Hospital of Central South University. Consent for publication: Not Applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of the recruitment procedure in this study
Fig. 2
Fig. 2
Association between insomnia and suicide attempts risk Model 1: Unadjusted; Model 2: Adjusted for demographics; Model 3: Adjusted for demographics and clinical Demographics: Age, gender and nationality Clinical: Anxiety, depression and stress
Fig. 3
Fig. 3
Association between eight items of AIS and risk of suicide attempts Model 1: Unadjusted. Model 2: Adjusted for age, gender and nationality. Model 3: Adjusted for age, gender, nationality, anxiety, depression and stress DSI: Difficulty with sleep induction. DA: Difficulty with awakening during the night. DE: Difficulty with early morning awakening. TST: Total sleep time. OQ: Overall quality of sleep. PSW: Problems with sense of well-being. PSF: Problems with sense of functioning. SD: Sleepiness during the day
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