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Abstract
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Suicidality in adolescents is a major public health concern and one of the main causes of death in this population over the world. The identification of potentially modifiable risk factors of suicidality among these population is crucial for clinical and overall health issues. Sleep has been considered an important potential risk factor as both social factors and biological features may lead to insufficient sleep in adolescence. Examining the association between sleep and youth suicidality may have crucial preventive, diagnostic and treatment implications. A quick search of the main databases of medical scientific literature revealed the presence of several systematic and non-systematic reviews already published on this topic. Therefore, summarizing all these data in a single review could be helpful to better understand this correlation and its implications. The type of article best fitting for this aim is the umbrella review, a review of systematic reviews/meta-analyses. By summarizing information from multiple overview articles, umbrella reviews make it easier to review the evidence and allow for comparison of results between each of the individual reviews. The primary aim of this umbrella review is to investigate if sleep difficulties could increase suicidal thoughts and behaviours (STBs) in adolescents. The secondary aims are to describe the characteristics of reviews addressing this PICO question and explore progress in the generation of evidence in this field. Only systematic reviews and meta-analyses on adolescents aged between 11-19 y, assessing at least one aspect of adolescent sleep (e.g., disorder, timing, duration or quality) in relation to at least one STB, have been included. Literature search has been conducted on PubMed, APA PsycInfo, Cochrane Library, Scopus, and Web of Science. Our results show a relevant correlation between sleep duration and STBs in adolescents. Furthermore, the results show a trend for the reduction of the risk of STBs when sleep duration increases. These findings are crucial for their implications in public health and clinical services, suggesting the potentiality of preventing suicidality through the increase of sleep duration. Future research will aim to implement more objective sleep measures (actigraphy, polysomnography) and to provide more longitudinal data with clinical and control groups to better establish the causal reationship between sleep and and STBs.
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