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

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.