Sleep challenges during childhood might be linked to an increased risk of suicide, suggests research.
At 10 years old, experiencing severe sleep issues could increase the likelihood of dealing with suicidal thoughts and attempts by 2.7 times within the subsequent two years, as suggested by a study published in JAMA Network Open on Monday. Approximately 30% of participants suffering from severe sleep troubles reported some form of suicidal behavior.
Senior study author Dr. Rebecca Bernert, a suicidologist and founder of the Stanford Suicide Prevention Research Laboratory in California, stated via email that as sleep is easily spotted as a risk factor, is non-stigmatizing, and highly treatable, it should be studied further as a risk factor and a crucial intervention target for youth suicide.
Suicide is one of the leading causes of death among children aged 10 to 14, a demographic also known for having high instances of sleep disturbances, as per the study.
Sleep disturbances have become a recognized risk factor for suicidal behaviors in mature adults, according to the authors, regardless of any associated depressive symptoms. Despite this, long-term examinations of suicidal behaviors, particularly during childhood's transition into early adolescence, have been rather scant.
The researchers utilized data from more than 8,800 children, all recruited by the Adolescent Brain Cognitive Development Study at 21 locations across the United States at the age of 9 or 10. The guardians completed questionnaires on their child's sleep health, taking into account factors such as difficulties in falling or staying asleep, waking up, excessive sleepiness, sleep-disorder breathing, excessive sweating during sleep, and activities occurring partially during deep sleep.
They also completed forms regarding their child's anxieties or depressive symptoms. The study gathered details about family history of depression, family conflict, and parental monitoring, as well.
When the participants were 11 or 12, 91.3% had not experienced suicidal thoughts or attempts during the past two years. However, among those who had, high and severe sleep disturbances were connected to a heightened likelihood of ideation and attempts, which stayed even after taking into account other risk factors like depression, anxiety, and family conflict or previous history of depression. The risk was observed to be greater among participants of color and female adolescents.
Frequent daily nightmares were also linked with a five-fold higher risk of suicidal behaviors.
The findings mirror the understanding that “sleep is essential for babies, but we tend to disregard its importance for kids, especially during adolescence and pre-adolescence,” said Dr. Christopher Willard, a Massachusetts-based psychologist and teaching associate in psychiatry at Harvard Medical School in Boston, via email. He wasn't part of the study.
The study has the potential to impact numerous disciplines.
According to Dr. Rebecca Berry, a clinical psychologist and adjunct clinical associate professor at New York University’s Grossman School of Medicine, via email, “Given the study’s design and large sample size from a younger, nonclinical population, the research has significant parental, clinical, and public health implications.” Berry wasn't involved in the study.
Why chronic sleep disruption could be related to suicide
Additional studies replicating the findings using objective sleep measurements and offering more insights into the frequency, nature, and emotional impact of nightmares would be beneficial, said Bernert, who also serves as an assistant professor of psychiatry and behavioral sciences at the Stanford University School of Medicine.
However, the connection's specific causes remain unclear. “Sleep is an indicator of our wellbeing and a vital window into our physical and emotional health,” Bernert said in a fact sheet provided to the media. “In this way, sleep may not offer an emotional refuge for distressed individuals.”
Insufficient sleep quality or quantity might impact brain function as well.
“Problems with sleep, lack of sleep — which can be caused by stress, activities, schoolwork, and indeed, screen time, all contribute to — interfere with brain development on several levels, but mainly mood, anxiety, and emotion regulation,” Willard said.
As a result of this lack of regulation, as well as fatigue, decision-making might become impaired. The ability to cope with stressors decreases, and impulsivity increases, while problem-solving becomes more challenging. Sleep also helps in regulating neurotransmitter levels, metabolism, brain plasticity, and the removal of toxic waste proteins from the brain.
Helping your child maintain good health
Good nighttime habits are essential in supporting children's health at all ages, according to Willard.
“Some of this is a broader conversation about homework expectations at that age, but in families, you can do what you can to keep bedtimes and routines consistent," he added.
Introduce a wind-down routine that commences an hour before bedtime, advisable by Berry. This routine should minimize screen time, homework, and physical activities as much as possible while including relaxing activities like light reading, journaling, or listening to calming music.
For children who have difficulty falling asleep, “parents may consider practicing mindfulness strategies with their child to support emotion regulation,” Berry said.
Good sleep hygiene is also facilitated through healthy habits during the day – such as exercise, sun exposure, stress management, and avoidance of daytime naps – she added.
READ MORE:Irritability or more? How to discern if your child is suffering from a mental health disorder
Sleep disturbances may be a symptom of various mental health conditions and ADHD, Willard explained.
“So if you notice a significant shift in your child's sleep patterns,” he advocated, “consult your pediatrician and monitor the situation closely, and consider alterations to your day and night routines.”
Initial remedies proven beneficial for teenagers encompass cognitive behavioral therapy for sleep disorders, labeled as CBTi, and the method of mental picture retraining for nightmares, according to Bernert.
At times, forewarning indications of a potential suicide attempt might not be foreseeable by loved ones or experts, but certain red flags may emerge, such as exaggerated emotional instability, pervasive feelings of despair, or disinterest in cherished activities. Engage in unreserved dialogues with your adolescent regarding their emotional well-being and consider consulting a professional for guidance.
Reports indicate that such parental participation can profoundly influence outcomes. Intriguingly, the researchers identified an uptick in active parental supervision, defined as a youth's perspective on family dinner frequency, familiarity with their location, or recognition of their social companions - this was linked to a 15% decrease in the likelihood of suicidal tendencies.
The study suggests that sleep disturbances, being a recognized risk factor for suicidal behaviors, should be further explored as a potential intervention target for reducing suicide rates in children and adolescents. Maintaining good sleep health, including consistent bedtimes and wind-down routines, can contribute to overall mental health and wellness in children.
