The trajectories and associations of sleep disturbance symptoms with suicidal ideation in adolescents: A three-wave longitudinal study

Abstract

Background: This study aimed to investigate the developmental trajectories of sleep disturbance symptoms and examine whether specific trajectory memberships of sleep disturbance symptoms could prospectively predict suicidal ideation (SI) among a large sample of Chinese adolescents over one year.

Methods: A three-wave longitudinal study was conducted from April 2021 to June 2022, with a sample of 19,095 adolescents from Shenzhen in Guangdong Province, China (51.2 % males; mean age = 12.4 ± 1.6 years at baseline). Socio-demographics (at baseline), SI, sleep disturbance symptoms (at each assessment), depressive symptoms (at the last follow-up), and negative life events (at two follow-ups) were assessed. Data were analyzed employing Growth Mixture Modeling and binary logistic regressions.

Results: The Growth Mixture Modeling identified four trajectories of sleep disturbance symptoms over one year: resistant group (76.2 %), delayed-dysfunction group (8.8 %), recovery group (7.4 %), and chronic-dysfunction group (7.6 %). Binary logistic regression analysis revealed that adolescents in the group of delayed-dysfunction (OR = 2.86, 95 % CI = 2.51-3.27) and chronic-dysfunction (OR = 2.14, 95 % CI = 1.84-2.47) exhibited higher risks of developing SI compared to those in the resistant group, even after controlling for socio-demographics, negative life events, depressive symptoms, and baseline SI.

Conclusions: These findings underscore the importance of identifying individuals at higher risks of sleep disturbance and providing personalized and effective mental health services to reduce the incidence of SI.

Keywords: Adolescent; Group-based trajectories; Longitudinal study; Sleep disturbance; Suicidal ideation.