Youth suicide has been increasing and became a public health concern worldwide. Identifying insufficient sleep as the potential risk factor is critical to reducing suicide risk and increasing trends. This study aimed to determine whether insufficient sleep is associated with increasing trends in suicidal behaviors and disparities by sex, age, and race/ethnicity among school adolescents. The present study used biennial data from the US nationally representative Youth Risk Behavior Survey from 2007 to 2019. Joinpoint regression models were used to estimate biennial percent changes (BPCs) and average BPCs (ABPCs) of suicidal behaviors by sleep duration. Logistic regression models were used to examine the association between insufficient sleep and suicidal behaviors. Of 73,356 adolescent students included (mean [standard deviation] age, 16.11 [1.23] years), 50.03% were female. Suicidal ideation and suicide plan among insufficient sleep group increased from 2007 to 2019 (BPC = 2.88% [95% confidence interval {CI}: 1.65%, 4.13%]; BPC = 3.42% [95% CI: 2.09%, 4.77%]), but were nonsignificant among sufficient sleep group. Trends in suicidal ideation (ABPC = 3.03% [95% CI: 1.35%, 4.73%]) and suicide plan (ABPC = 4.03% [95% CI: 2.47%, 5.62%]) among female adolescents with insufficient sleep increased, but nonsignificant among male adolescents with insufficient sleep. Suicidal ideation (ABPC = 1.73% [95% CI: 0.51%, 2.97%]) and suicide plan (ABPC = 2.31% [95% CI: 0.70%, 3.95%]) increased among younger adolescents only with insufficient sleep, whereas suicide trends by sleep duration were similar among older adolescents. Suicide plan among insufficient sleep group increased across the four racial groups, with BPC highest for the White (BPC = 3.48% [95% CI: 1.31%, 5.69%]), and lowest for the Hispanic/Latino (BPC = 1.18% [95% CI: 0.15%, 2.23%]), but were nonsignificant among sufficient sleep group except for the White (BPC = 2.83% [95% CI: 0.62%, 5.09%]). Insufficient sleep was disproportionately associated with increasing trends in suicidal behaviors among female, younger, and non-White adolescent students. Ensuring sufficient sleep can potentially reduce suicide among school adolescents.

中文翻译：

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睡眠不足与青少年自杀行为的增加趋势有关


青少年自杀人数不断增加，并成为全球公共健康问题。将睡眠不足​​确定为潜在的危险因素对于降低自杀风险和增加自杀趋势至关重要。本研究旨在确定睡眠不足是否与自杀行为的增加趋势以及学校青少年的性别、年龄和种族/民族差异有关。本研究使用了 2007 年至 2019 年美国全国代表性青少年风险行为调查的两年期数据。连接点回归模型用于估计按睡眠时间划分的自杀行为的两年期百分比变化 (BPC) 和平均 BPC (ABPC)。使用逻辑回归模型来检查睡眠不足与自杀行为之间的关联。在 73,356 名青少年学生中（平均[标准差]年龄，16.11[1.23]岁），50.03% 是女性。 2007年至2019年，睡眠不足组的自杀意念和自杀计划有所增加（BPC = 2.88% [95%置信区间{CI}: 1.65%, 4.13%]；BPC = 3.42% [95% CI: 2.09%, 4.77%] ），但在充足睡眠组中不显着。睡眠不足的女性青少年自杀意念 (ABPC = 3.03% [95% CI: 1.35%, 4.73%]) 和自杀计划 (ABPC = 4.03% [95% CI: 2.47%, 5.62%]) 趋势有所增加，但在睡眠不足的男性青少年中不显着。仅在睡眠不足的青少年中，自杀意念（ABPC = 1.73% [95% CI: 0.51%, 2.97%]）和自杀计划（ABPC = 2.31% [95% CI: 0.70%, 3.95%]）才会增加，而自杀率则更高年龄较大的青少年的睡眠持续时间趋势相似。四个种族群体中睡眠不足群体的自杀计划均有所增加，其中白人的 BPC 最高（BPC = 3.48% [95% CI: 1.31%, 5.69%]），西班牙裔/拉丁裔最低（BPC = 1.18% [95% CI: 0.15%, 2.23%]），但除白人外，在充足睡眠组中不显着（BPC = 2.83% [95% CI: 0.15%, 2.23%]） : 0.62%, 5.09%]）。睡眠不足与女性、年轻学生和非白人青少年学生自杀行为的增加趋势不成比例地相关。确保充足的睡眠可能会减少在校青少年的自杀率。