Association Between Insufficient Sleep, Depressive Symptoms, and Suicidality Among Florida High School Students

INTRODUCTION: Emerging research suggests insufficient sleep can heighten the risk of poor mental health among adolescents. We examined the relationship between sleep, depressive symptoms, and suicidal thoughts and behaviors among Florida high school students. METHODS: Data were from the 2021 Florida High School Youth Risk Behavior Survey, a statewide representative sample of students in grades 9 to 12. We estimated prevalence of 1 indicator of depressive symptoms — feeling sad or hopeless for 2 or more weeks — and 2 indicators of suicidality — having considered attempting suicide and making a suicide plan — by insufficient sleep status (<8 h of sleep on an average school night). Multivariate logistic regressions were used to calculate odds ratios measuring the association between insufficient sleep, poor mental health, and suicidality. RESULTS: Compared with students reporting sufficient sleep, those with insufficient sleep were more likely to feel sad or hopeless (42.7% vs 28.1%), have considered suicide (19.1% vs 12.5%), or have made a suicide plan (14.8% vs 9.6%). In adjusted multivariate models, compared with students with sufficient sleep, students with insufficient sleep had higher odds of feeling sad or hopeless (adjusted odds ratio [AOR] = 1.83; 95% CI 1.54–2.17), and having made a plan about how they would attempt suicide (AOR = 1.32; 95% CI, 1.00–1.74), but did not have significantly higher odds of having seriously considered suicide. CONCLUSION: Increased attention to sleep as a modifiable risk factor for mental health among adolescents is particularly important because of the many less modifiable factors that contribute to mental health difficulties in this population. Adolescent mental health programs should consider sleep an important factor in suicide prevention.