Poor Sleep Linked To Suicidal Behavior Among Children And Adolescents With Depressive Episodes

The study, authored by Maria-Cecilia Lopes, MD, PhD, of Sao Paulo University in Brazil, focused on 303 individuals with pediatric bipolar disorder and pediatric unipolar disorder during depressive episodes. The presence of sleep complaints and suicidal behavior were detected by face-to-face interviews during depressive episodes.

According to the results, 83.8 percent of the patients had sleep disturbances. Poor sleep was more frequent among those with pediatric bipolar disorder and pediatric unipolar disorder, and this was clearly detected by the presence of initial insomnia and sleep maintenance insomnia. Surprisingly, there was a significant association between suicidal behavior and the presence of sleep complaints in both groups. The proportion of subjects who reported suicidal behaviors with sleep complaints was higher among bipolar than unipolar patients.

"There is a strong association between depression and sleep deprivation. The suicidal behavior associated with depression has been described as a public health problem and that the full implication might not be scientifically addressed in relation to children and adolescents to the depth that it should be. Moreover, the suicidal behavior in adults can start in childhood and it should be recognized early," said Dr. Lopes.

The presence of sleep complaints during depressive episodes in pediatric bipolar and unipolar disorders must lead to a search for suicidal behavior, said Dr. Lopes, adding that there are clinical neurobiological issues about these findings that need to be clarified.

"In my opinion, these differences show that sleep complaints between both groups can help the diagnosis processes, and that a follow-up of the pediatric population with their depressive episodes should be adhered to," noted Dr. Lopes.

It is recommended that adolescents get nine hours of nightly sleep and school-aged children between 10-11 hours.

The American Academy of Sleep Medicine (AASM) offers the following tips to adolescents on how to get a good night's sleep:

• Follow a consistent bedtime routine.
• Establish a relaxing setting at bedtime.
• Get a full night's sleep every night.
• Avoid foods or drinks that contain caffeine, as well as any medicine that has a stimulant, prior to bedtime.
• Do not stay up all hours of the night to "cram" for an exam, do homework, etc. If after-school activities are proving to be too time-consuming, consider cutting back on these activities.
• Keep computers and TVs out of the bedroom.
• Do not go to bed hungry, but don't eat a big meal before bedtime either.
• Avoid any rigorous exercise within six hours of your bedtime.
• Make your bedroom quiet, dark and a little bit cool.
• Get up at the same time every morning.