Sarchiapone M et al. Hours of sleep in adolescents and its association with anxiety, emotional concerns, and suicidal ideation. Sleep Med. 2014 Feb;15(2):248-54. PMID: 24424101.

Sleep Med. 2014 Feb;15(2):248-54. doi: 10.1016/j.sleep.2013.11.780. Epub 2013 Dec 18.

Hours of sleep in adolescents and its association with anxiety, emotional concerns, and suicidal ideation.

Sarchiapone M(1), Mandelli L(2), Carli V(3), Iosue M(4), Wasserman C(5), Hadlaczky G(6), Hoven CW(7), Apter A(8), Balazs J(9), Bobes J(10), Brunner R(11), Corcoran P(12), Cosman D(13), Haring C(14), Kaess M(15), Keeley H(12), Keresztény A(9), Kahn JP(16), Postuvan V(17), Mars U(17), Saiz PA(10), Varnik P(18), Sisask M(18), Wasserman D(3).

Author information:
(1)Department of Heath Sciences, University of Molise, Campobasso, Italy. Electronic address: marco.sarchiapone@me.com.
(2)Department of Heath Sciences, University of Molise, Campobasso, Italy; Department of Biomedical and Neuromotor Sciences, Psychiatric Section, University of Bologna, Italy; National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute (KI), Stockholm, Sweden.
(3)National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute (KI), Stockholm, Sweden; WHO Collaborating Centre for Research, Methods Development and Training in Suicide Prevention, Stockholm, Sweden.
(4)Department of Heath Sciences, University of Molise, Campobasso, Italy.
(5)Department of Heath Sciences, University of Molise, Campobasso, Italy; Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, USA.
(6)National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute (KI), Stockholm, Sweden.
(7)Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA.
(8)Feinberg Child Study Centre, Schneider Children's Medical Centre, Tel Aviv University, Tel Aviv, Israel.
(9)Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary; Semmelweis University, School of Ph.D. Studies, Budapest, Hungary.
(10)Department of Psychiatry, School of Medicine, University of Oviedo, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Oviedo, Spain.
(11)Section for Disorders of Personality Development, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.
(12)National Suicide Research Foundation, Cork, Ireland.
(13)Clinical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
(14)Research Division for Mental Health, University for Medical Information Technology (UMIT), Innsbruck, Austria.
(15)Section for Disorders of Personality Development, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany; Orygen Youth Health, Melbourne, Australia.
(16)Department of Psychiatry, Centre Hospitalo-Universitaire CHU de NANCY, Université H. Poincaré, Nancy, France.
(17)Slovene Centre for Suicide Research, Andrej Marušič Institute, University of Primorska Muzejski trg 2, 6000 Koper, Slovenia.
(18)Estonian-Swedish Mental Health & Suicidology Institute, Center for Behavioral and Health Sciences, Tallinn, Estonia; Tallinn University, Tallinn, Estonia.

OBJECTIVES: Anxiety and concerns in daily life may result in sleep problems and consistent evidence suggests that inadequate sleep has several negative consequences on cognitive performance, physical activity, and health. The aim of our study was to evaluate the association between mean hours of sleep per night, psychologic distress, and behavioral concerns.

METHODS: A cross-sectional analysis of the correlation between the number of hours of sleep per night and the Zung Self-rating Anxiety Scale (Z-SAS), the Paykel Suicidal Scale (PSS), and the Strengths and Difficulties Questionnaire (SDQ), was performed on 11,788 pupils (mean age±standard deviation [SD], 14.9±0.9; 55.8% girls) from 11 different European countries enrolled in the SEYLE (Saving and Empowering Young Lives in Europe) project.

RESULTS: The mean number of reported hours of sleep per night during school days was 7.7 (SD, ±1.3), with moderate differences across countries (r=0.06; P<.001). A reduced number of sleeping hours (less than the average) was more common in girls (β=0.10 controlling for age) and older pupils (β=0.10 controlling for sex). Reduced sleep was found to be associated with increased scores on SDQ subscales of emotional (β=-0.13) and peer-related problems (β=-0.06), conduct (β=-0.07), total SDQ score (β=-0.07), anxiety (Z-SAS scores, β=-10), and suicidal ideation (PSS, β=-0.16). In a multivariate model including all significant variables, older age, emotional and peer-related problems, and suicidal ideation were the variables most strongly associated with reduced sleep hours, though female gender, conduct problems measured by the SDQ, and anxiety only showed modest effects (β=0.03-0.04).

CONCLUSIONS: Our study supports evidence that reduced hours of sleep are associated with potentially severe mental health problems in adolescents. Because sleep problems are common among adolescents partly due to maturational processes and changes in sleep patterns, parents, other adults, and adolescents should pay more attention to their sleep patterns and implement interventions, if needed.

Copyright © 2013 Elsevier B.V. All rights reserved.

PMID: 24424101 [PubMed - indexed for MEDLINE]

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