Association between sleep duration, suicidal ideation, suicidal attempt and suicidal behavior among Chinese adolescents

Background: A relatively small number of studies have researched the relationship between sleep duration and suicidal ideation, attempts, and behavior. This research aims to investigate the link between sleep duration and suicide in Chinese adolescents, and to examine the role of depression as a mediating factor. Method: Data were collected from 3315 students using a multi-stage random cluster sampling method and selfadministered questionnaires. The study applied logistic regression to investigate the relationship between sleep duration and various forms of suicidal behavior, and mediation analysis to understand how depression might influence this relationship. Results: The average sleep duration among the adolescents was 7.25 h (+/- 0.20), +/- 0.20), with 59.67 % reporting insufficient sleep. The logistic regression analysis showed that longer sleep duration is linked with lower risks of suicidal ideation (OR: 0.753, 95%CI: CI : 0.696 to 0.814), suicidal attempts (OR: 0.830, 95%CI: CI : 0.748 to 0.922), and suicidal behavior (OR: 0.841, 95%CI: CI : 0.713 to 0.992). Analysis using restricted cubic spline plots indicated the connection between sleep duration and these suicidal factors was not linear. The study found that depression plays a partial mediating role between sleep duration and suicidal ideation, with an effect of 52.29 %. Limitations: The cross-sectional study design could not prove causation. Conclusions: There is a clear non-linear association between sleep duration and suicidal tendencies in adolescents, with depression acting as a mediator. This suggests that future research could focus on sleep and mood management as ways to address suicide risk in this age group.