Poor sleep linked to suicidal behavior among children and adolescents with depressive episodes

A research abstract that will be presented on Thursday at SLEEP 2008, the 22nd Annual Meeting of the Associated Professional Sleep Societies (APSS), finds a link between poor sleep and 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.

The AASM offers some tips to help your child sleep better:

• Follow a consistent bedtime routine. Set aside 10 to 30 minutes to get your child ready to go to sleep each night.

• Establish a relaxing setting at bedtime.

• Interact with your child at bedtime. Don’t let the TV, computer or video games take your place.

• Keep your children from TV programs, movies, and video games that are not right for their age.

• Do not let your child fall asleep while being held, rocked, fed a bottle, or while nursing.

• At bedtime, do not allow your child to have foods or drinks that contain caffeine. This includes chocolate and sodas. Try not to give him or her any medicine that has a stimulant at bedtime. This includes cough medicines and decongestants.

It is important to make sure that your child gets enough sleep and sleeps well. The value of sleep can be measured by your child’s smiling face, happy nature and natural energy. A tired child may have development or behavior problems. A child’s sleep problems can also cause unnecessary stress for you and the other members of your family.

Those who suspect that they might be suffering from insomnia, or another sleep disorder, are encouraged to consult with their primary care physician or a sleep specialist. Parents should consult with their child’s pediatrician or a sleep specialist.

Source: American Academy of Sleep Medicine