Sleep measures as a predictor of suicidal ideation among high-risk adolescents

Roy Ratzon, Joel Reiter, Tanya Goltser-Dubner, Ronen Segman, Esti Galili Weisstub, Fortunato Benarroch, Shlomo Rahmani Zwi Ran, Ella Kianski, Ruth Giesser, Pnina Blum Weinberg, Amichai Ben-Ari, Yaron Sela, Moriah Bar Nitsan, Amit Lotan, Amit Shalev

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Suicide is the second leading cause of death among youth aged 15–24 years. Identifying modifiable risk factors relevant to adolescents is crucial for suicide prevention. Sleep patterns have been linked to suicidality in adults, but lack sufficient study in youth. This ecological momentary assessment (EMA) study aimed to explore the relationship between objectively and subjectively measured sleep characteristics and next-day suicidal ideation in high-risk youth. We included 29 adolescents (12–18 years old) admitted to the inpatient psychiatric ward post-suicide attempt or due to suicidal intent within the previous month. We conducted objective (actigraphy) and subjective (sleep diary) sleep pattern assessments over ten consecutive days. Daily suicidal ideation was evaluated using a questionnaire based on the validated C-SSRS interview. A significant positive association was observed between sleep onset latency (SOL) and expressing a "death wish" the following day (OR = 1.06, 95% CI [1–1.11], p =.04), with each minute of longer SOL increased the risk for a death wish the following day by 6%. In addition, a marginally significant negative association was observed between total sleep time (TST) and expressing a "death wish" the following day (OR = 0.57, 95% CI [0.3–1.11], p = 0.1), with each one-hour decrease in objectively measured TST increasing the odds of a death wish by 43%. Our study highlights the interplay between sleep patterns and suicidal ideation, with SOL and TST playing a significant role that may function as proximal risk factors for suicidality and as a target for intervention while treating suicidal youth.

Original languageEnglish
JournalEuropean Child and Adolescent Psychiatry
StateAccepted/In press - 2024


  • Actigraphy
  • Adolescence
  • Risk factors
  • Sleep patterns
  • Suicidal ideation
  • Suicide


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