Teenagers who usually fall into bed at 2 a.m. each night and get up a few hours later to make their 8 a.m. classes are putting themselves at risk for more than chronic tiredness.

New findings show that adolescents who do not get enough sleep may be more likely to have suicidal thoughts and to attempt suicide than their more well-rested peers. Such suicidal behavior is also evident among those who experience frequent nightmares, according to the study of young Chinese people.

"These findings ... highlight the potential role of sleep intervention in the prevention of adolescent suicide," writes study author Dr. Xianchen Liu of Arizona State University's Prevention Research Center and Shandong University School of Public Health in the People's Republic of China.

While adults need eight hours of sleep on average, experts recommend that adolescents -- whose bodies undergo big growth spurts and hormonal changes -- sleep at least nine hours every night, Liu explained.

Yet many teenagers get far less sleep than they should, which, studies show, affects their thinking, concentration, school performance and behavior. It is also known that suicide risk increases during adolescence.

Two long-term studies of adults have found that completed suicide can be predicted by poor sleep quality and nightmares, but less information is known about the sleep-suicide association among adolescents.

To investigate, Liu analyzed survey responses from 1,362 students from three junior and two senior high schools in a rural area of a province in eastern China. The students were asked about their sleep patterns and problems and their suicidal behavior.

Nearly 20 percent of the students said they had thought about killing themselves, and 10.5 percent admitted attempting suicide at some point during the previous six months, Liu reports in the October issue of the journal Sleep.

About 17 percent reported having insomnia, and a small proportion (2.3 percent) said they had even taken pills to help them go to sleep.

The students generally reported getting about 7.6 hours of sleep each night. And, study findings show, the less sleep the adolescents had, the more likely they were to report having attempted suicide.

Those who slept less than eight hours each night were about three times more likely to attempt suicide than those who slept a minimum of nine hours.

This finding remained true even when Liu took into consideration the teenagers' depressive symptoms and other factors that could potentially skew the results, the report indicates.

In addition, adolescents who said they had experienced frequent nightmares during the past month were more than twice as likely to attempt suicide as those who rarely experienced nightmares. Further, those who reported having frequent or occasional nightmares - as did almost half of the students - were up to 75 percent more likely to have suicidal thoughts than those who rarely had such frightening dreams.

Various researchers have reported that sleep loss may lead to anxiety, depression, aggressive behavior, decreased brain function and hormonal or immunological changes, Liu stated.

"All of these impairments due to sleep loss may directly or indirectly lead to elevated risk for adolescent suicidal behavior," he said.

Parents who know their teen is getting only a few hours of sleep each night need not be alarmed about any potential suicidal behavior, according to the researcher, unless they notice warning signs such as their child giving away prized possessions or making out a will.

If those signs are present, Liu advises that parents "consult a clinical psychologist or psychiatrist, to assess the potential risk... and see a sleep specialist to look for the reasons of sleep loss if short sleep has impacted the child's daytime functioning."

Dr. Rosalind Cartwright, chair of the psychology department at Rush University Medical Center in Chicago, Illinois said that Liu's study shows that sleep deprivation among teens is a "worldwide problem."

Adolescents "need more and get less (sleep) than any other age group," said Cartwright, who was not involved with the study, but has conducted sleep-related research. She added that adolescents, and their parents, should "make sleep a priority."

SOURCE: Sleep, October 2004.

Reference Source 89
October 25, 2004

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