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Having severe sleep disturbances at age 10 was linked with having a 2.7 times higher risk for suicidalideation and suicide attemptstwo years later, according to astudy published Mondayin the journal JAMA Network Open. Nearly 1 in 3 participants with severe sleep disturbance later reported some level of suicidal behavior.

“Given that sleep is highly visible as a risk factor, non-stigmatizing, and highly treatable … we suggest study of sleep as a risk factor and critical intervention target for youth suicide,” said senior study author Dr. Rebecca Bernert, a suicidologist and founder of the Stanford Suicide Prevention Research Laboratory in California, via email.

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Guardians also completed forms about their child’s anxiety or depression symptoms. The authors obtained details on family history of depression, family conflict and parental monitoring as well.

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“The brain is changing as much during those years as in that first year of life, which is why that age sleeps so much and needs so much sleep to develop the way it needs to,” Willard said.

Given the study’s design and large sample size of a younger, nonclinical population, the research has “significant parental, clinical, and public health implications,” said Dr. Rebecca Berry, clinical psychologist and adjunct clinical associate professor at New York University’s Grossman School of Medicine, via email. Berry wasn’t involved in the study.

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“It’s important to note that in a study like this, we don’t want to assume that the poor sleep caused the suicidal behavior — we are just seeing a connection between the two,” said Dr. Neha Chaudhary, a child and adolescent psychiatrist at Massachusetts General Hospital and Harvard Medical School in Boston, via email. Chaudhary wasn’t involved in the study.

It’s possible that sleep disturbances could be early signs of mental health struggles that later worsen, Chaudhary, chief medical officer at Modern Health, said.

But as to what may explain the associations found, “sleep is a barometer of our well-being, and an important window into our physical and emotional health,” Bernert said in a fact sheet provided to the media. “In this way, sleep may fail to provide an emotional refuge for distressed individuals.”

“Problems with sleep, lack of sleep — which too much stress, activities, schoolwork and yes, screen time, all contribute to — interfere with brain development on a number of levels, but particularly mood, anxiety and emotion regulation,” Willard said.

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“Some of this is a larger conversation about homework expectations at that age,” he added, “but in families you can do what you can to keep bedtimes and routines consistent.”

Create a wind-down routine that starts an hour before bedtime, Berry said. It should limit screen time, homework and physical activity as much as possible and include relaxing activities such as light reading, journaling or listening to calming music.

For kids whostruggle with restlessnessat bedtime, “parents may consider practicing mindfulness strategies with their child to support emotion regulation,” Berry said.

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“So if you notice your child’s sleep patterns changing drastically,” he added, “check with your pediatrician and keep an eye on it, and consider ways to adjust the day and night routines.”

First-line treatments found to be effective for adolescents include cognitive behavioral therapy for insomnia, known as CBTi, andimagery rehearsal treatment for nightmares, Bernert said.

Experts and loved ones can’t always predict a suicide attempt, but sometimesthere are warning signs, including extreme mood swings, hopelessness or loss of interest in activities. Have open conversations with your child about their mental health and seek help from a professional.

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Editor’s Note:If you or someone you know is struggling with suicidal thoughts or mental health matters, confidential support from trained counselors is available by phone, text or chat by dialing 988 or visiting the988 Lifeline website.

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