Examining the Association Between Sleep Deficiencies and Suicidal Ideation in Peripubertal Youth Receiving Intensive Psychiatric Services: A Multi-Modal Approach - PROJECT SUMMARY Suicide rates among peripubertal youth have tripled in the last decade, and suicide is the second leading cause of death for adolescents. Despite alarming increases in preadolescent suicide, little is known about the day-to-day dynamics of suicide risk, especially among pre-adolescent youth experiencing severe stress and psychopathology. One factor unique to this developmental stage that could explain why suicidal thoughts and behaviors (STB) increase dramatically is sleep disruption. Peripuberty is uniquely sensitive to poor sleep health, and research suggests that suicide risk during adolescence coincides with changes in sleep-wake and circadian regulation. However, despite evidence supporting both sleep and STB being dynamic and development processes, almost all research to date has focused on adults and used retrospective or long follow-up periods. which substantially limits the clinical translation of research to this vulnerable population. We propose to examine the dynamic influence of sleep deficiencies (e.g., insufficient duration, irregular timing, poor quality) on next-day suicidal ideation (SI) in a high-risk peripubertal youth population. We will examine three domains of sleep deficiencies using subjective daily diaries and objective passive wrist-based actigraphy and heart rate. We will also explore the influence of potential confounding or amplifying factors, including depressive symptoms severity, pubertal stage, sex, and childhood adversity exposure. We aim to overcome the limitations of previous research by using (1) a high-risk sample of peripubertal youth (ages 9-12), (2) a multi-model assessment of sleep deficiencies, and (3) a 30-day daily diary (N = 150) and passive actigraphy assessment (n = 50) of sleep. We hypothesize that shorter sleep duration, lower quality, and later or more variable timing will longitudinally predict heightened next-day SI. This will be the first study examining sleep deficiencies and prospective SI within peripubertal youth. Findings have a high potential to impact our understanding of early risk identification and, ultimately, the prevention of the dramatic escalation in STB risk from childhood to adolescence. Additionally, this proposed project will be instrumental to the Applicant’s professional trajectory and long-term goals of pursuing a clinical research career in a medical center setting.
