SfN14 Blogging: The Invisible Variable: Sleepiness and suicidality in a large college health survey

I can get no sleep by Bistra Ivanova

Alexis Tarter is a Senior undergraduate in the Neuroscience program at the University of St. Thomas in St. Paul, MN. She's been interested in the brain since middle school when she began to understand her great-grandfather's death from Alzheimer's disease.She began performing research earlier than typical college students: as a freshman. She has studied memory from several angles and found that she prefers research in humans to wet bench neuroscience. When she took a Sleep and Circadian Rhythm class from Dr. J. Roxanne Prichard she was impressed by how sleep is involved in so many bodily functions, particularly mood. She began working with Dr. Prichard to study the effect of sleep on suicidality in college students.

College students, at 18-24 years old, have a high prevalence of depression and stress. In fact, suicide is the second leading cause of death for this age group. Several studies suggested there may be a link between insufficient sleep, depression, and suicidal ideation. Based on these studies, Lexi developed her research project. She used open data sets from the American College Health Association (ACHA) and the National College Health Assessment II (NCHA) to "determine if sleep problems are associated with an increased risk for suicidality".

If you aren't already impressed with Lexi and her research get this: for this study she had 72,966 undergraduate students in her final data set! Approximately 25% of the students had some form of sleep problems and almost 20% had formally diagnosed or probable depression.

Lexi grouped the data based on a combination of two factors: depression or sleep difficulties. The groups were:

1)    Students without depression or sleep difficulties

2)    Students with only sleep difficulties

3)    Students with only depression and

4)    Students with both depression and sleep difficulties.

Then she looked at the percent of students in each group that:

1)    Attempted suicide in the last year

2)    Had suicidal ideation in the last year or

3)    Intentionally harmed themselves physically (self-harm, such as cutting) in the last year.

Her data showed that the percent of students attempting or thinking about suicide or harming themselves was increased in groups with depression only, sleep difficulties only, and both depression and sleep difficulties. The increase was more dramatic between the sleep difficulties only and depression only groups but was higher yet in the group with both factors.

Lexi's conclusions were that insomnia and self-identified sleep difficulties greatly increased the risk for suicidal attempts, ideation, and self harm. College students are known for late night study sessions and a lack of sleep especially on weeknights. Dr. Prichard says that their behavior can be influenced when they're armed with information based on science. In another study, when told that people can bench press more weight if they're well rested or that increased sleep hours correlates with better grades, students will actually attempt to get more sleep. This is great news for Lexi's findings because it suggests that suicide interventions can be tailored to include sleep as a factor.

In the future, Dr. Prichard's group will investigate potential gender or other sub-group differences and analyze intervention strategies.