title: The prospective relationship between sleep problems and suicidal behavior in the National Longitudinal Study of Adolescent Health.
abstract: OBJECTIVE
  Previous research has found a longitudinal relationship between sleep problems and suicidal behavior while controlling for depression and other important covariates in a high risk sample of adolescents and controls. In this paper, we replicated this longitudinal relationship in a national sample and examined whether the relationship was partially mediated by depression, alcohol-related problems and other drug use.
  
  
  METHODS
  Study participants were 6504 adolescents from the National Longitudinal Study of Adolescent Health (ADD HEALTH).
  
  
  RESULTS
  In bivariate analyses, sleep problems (i.e., having trouble falling asleep or staying asleep) at Wave 1 were associated with suicidal thoughts and suicide attempts at Waves 1, 2, and 3 (W1, 2 and 3). In multivariate analyses, controlling for depression, alcohol problems, illicit drug use, and important covariates such as gender, age, and chronic health problems, sleep problems at a previous wave predicted suicidal thoughts and suicide attempts at a subsequent wave. In mediation analyses, W2 depression significantly mediated the effect of W1 sleep problems on W3 suicide thoughts. Moreover, W2 suicidal thoughts also significantly mediated the effect of W1 sleep problems on W3 suicidal attempts.
  
  
  CONCLUSIONS
  Sleep problems appear to be a robust predictor of subsequent suicidal thoughts and attempts in adolescence and young adulthood. Having trouble falling sleeping or staying asleep had both direct and indirect effects (via depression and suicidal thoughts) on suicidal behavior. Future research could determine if early intervention with sleep disturbances reduces the risk for suicidality in adolescents and young adults.
authors.affiliation: Department of Psychology, Idaho State University, Pocatello, ID 83209-8112, USA. wongmari@isu.edu
authors.forename: Maria M
authors.initials: MM
authors.lastname: Wong
authors.forename: Kirk J
authors.initials: KJ
authors.lastname: Brower
mesh_terms: D000293:Adolescent; D000367:Age Factors; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000523:psychology*; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data; D014481:United States; D055815:Young Adult