Correlations Of Sleep Characteristics And Suicide Risk Among Adolescents With Depression

BackgroundThe prevalence of adolescent depression has increased dramatically,resulting in long-term impairment of an individual’s broad range of interpersonal,educational,occupational,social functioning,and family roles,with the most serious adverse consequence being suicide,and suicidal behavior being the leading cause of death among adolescents.Adolescents with depression often have disturbed sleep-wake cycles and circadian rhythms.Adolescents with sleep disorders are at higher risk for later depression than previously estimated and are associated with suicidal ideation,suicide attempts,and death by suicide.However,there is a lack of uniform evaluation of the subjective and objective sleep status of depressed adolescents in clinical observational studies.ObjectiveAdolescents with depressive disorders are at an increased risk of suicide,and sleep problems may exacerbate the risk of suicide in this clinical population.The aim of this study was to investigate the sleep characteristics of adolescent depressed patients in the clinic and their relationship with suicide risk,and to provide a reference for the identification and monitoring of suicide risk in adolescent depressed patients.MethodThe study was a cross-sectional design and population consisted of adolescent depressed patients treated in inpatient and outpatient settings at the Affiliated Brain Hospital of Guangzhou Medical University from January 2022 to September 2022.Data information such as demographic data,medical history and treatment records,and clinical characteristics of the study subjects were collected through the data platform based on the South China adolescent depression data follow-up platform.The sleep structure of patients was assessed using Polysomnography(PSG)parameters.Clinical sleep status was assessed using the Athens Insomnia Scale(AIS)and The Epworth Sleeping Scale(ESS),The Columbia-Suicide Severity Rating Scale(C-SSRS)was used to assess patients’ suicidal ideation and suicide attempts,and the Hamilton Depression Rating Scale(HAMD)and Hamilton Anxiety Rating Scale(HAMA)were used to assess patients’ depression and anxiety levels.For statistical analysis,patients were evaluated for suicidal ideation and suicide attempts according to the C-SSRS and were divided into suicidal ideation group(SI group)and non-suicidal ideation group(NSI group),and suicide attempt group(SA group)and non-suicide attempt group(NSA group)accordingly.Differences between groups were compared according to whether patients had suicidal ideation/attempt groups,using Spearman correlation analysis to examine the correlation between Clinical Sleepiness Scale scores/PSG indicators and depressive symptoms and suicidal ideation,and potential predictors of suicide risk in adolescent depressed patients were analyzed using logistic regression with the presence or absence of suicidal ideation/attempt as the dependent variable in sleep-related parameters.Results1.Demographic Factors and Clinical Characteristics of Suicide Risk in Adolescents with DepressionFemales with adolescent depression had a higher risk of suicidal ideation(OR=1.91,P=0.043)and attempted suicide(OR=2.81,P=0.002)than males,and patients with more hospitalizations had a higher risk of attempted suicide(OR=1.63,P=0.001).2.Association between PSG and suicidal ideation in adolescent depressionThere was no discernible difference in objective PSG between the two groups(P>0.05).According to Logistic regression,suicidal ideation in teenage depressive 5 inpatients was not significantly influenced by the PSG characteristics(P>0.05).3.Association between PSG and suicide attempts in adolescent depressionFor PSG characteristics,REM latency was significantly shorter in individuals with suicide attempts relative to those without(t=-1.995,P=0.046).Logistic regression indicated that REM latency was connected with the probability of suicide attempts after accounting for general demographic variables and depressive symptoms(β=0,OR=0.99,95%CI:0.98,1,P=0.041).4.The relationship between clinical sleep scale score and suicidal ideation in adolescents with depressionSuicidal adolescents had more severe nocturnal insomnia(total AIS score;t=-3.236,P=0.001)and daytime sleepiness symptoms(total ESS score;t=-2.613,P=0.009).The results of a Spearman correlation analysis revealed that AIS-assessed sleep problems and their two sleep factors(nighttime sleep and daytime functioning)were significantly and positively correlated with suicidal ideation.After controlling for general demographic information and depressive symptoms,Logistic regression revealed that the lower the daytime functioning,the higher the risk of suicidal ideation in depressed adolescents(β=0.2,OR=1.2,95%CI:1.01,1.44,P=0.035).5.The relationship between clinical sleep scale score and suicide attempts in adolescents with depressionRelative to depressed adolescents without suicide attempts,those who attempted suicide had worse sleep status(AIS total score;t=-2.217,P=0.012).After accounting for general demographic data,Logistic regression revealed a connection between the total AIS score and suicide attempts(β=0.1,OR=1.05,95%CI:1.01,1.1,P=0.014);but,the association vanished after accounting for depressive symptoms(β=0,OR=1.03,95%CI:0.99,1.08,P=0.184).ConclusionThere was no significant correlation between PSG measures for adolescent depression and suicidal thoughts.In teenagers with depression,shortened REM latency is a risk factor for suicide attempt risk.Subjective sleep problems were prominent among depressed adolescents with suicidal ideation,and daytime 6 dysfunction was an independent influence on the risk of suicidal ideation in adolescent depression.There was no statistically significant link between the total amount of sleep issues and the probability of suicide attempts in adolescent depression.Fundamental to preventing suicide is examining the connections that connect sleep issues and the risk of taking one’s own life during depressive episodes.Clinicians must take this into account when evaluating and treating sleep issues in the context of suicide risk.In addition,gender should be taken into account when assessing the suicide risk of patients.Female patients have a higher risk of suicide,which is also necessary in the prevention of suicide.