Summary: A major longitudinal study finds that teenagers who sleep less or experience frequent night awakenings are substantially more likely to attempt suicide later in adolescence. Analysing data from over 8,500 young people, researchers discovered that poor sleep at age 14 predicted suicide attempts by age 17, even after taking into account other established mental health risk factors.
The evidence shows that shorter time in bed on school nights and fragmented sleep are stronger predictors of later suicide attempts than depressive symptoms alone. This suggests that improving sleep among adolescents could be an effective, practical target for suicide prevention strategies.
Key Facts:
- Long-term risk: Teens reporting shorter time in bed or disrupted sleep at 14 were more likely to attempt suicide by 17.
- Independent predictor: Sleep problems predicted later suicide attempts even after controlling for socioeconomic status, prior self-harm, and other mental health difficulties.
- Protective role: Better rational decision-making reduced risk, but its protective effect was weakened by frequent sleep disruption.
Source: University of Warwick
Headline finding: Teenagers who do not get enough sleep on school nights, or who wake frequently during the night, face an elevated risk of attempting suicide in later adolescence, new research from the University of Warwick reports.
Suicide remains one of the leading causes of death among adolescents in the UK. Teenagers often miss sleep for a range of biological and social reasons, but until now the long-term effects of this sleep loss on suicide risk were not well established. This study provides clear longitudinal evidence linking sleep problems in early adolescence with later suicide attempts and examines cognitive factors that may influence that link.
The study, published in Sleep Advances, analysed data from the Millennium Cohort Study (MCS). Researchers examined sleep patterns reported at age 14 and linked them to self-reported suicide attempts at age 17. The sample included over 8,500 participants, making the findings robust and nationally representative.
Lead researcher Michaela Pawley, a PhD candidate in the Department of Psychology at the University of Warwick, noted that adolescence is a pivotal period when both sleep problems and suicide risk often emerge. She emphasized that poor sleep should be viewed not only as a symptom of wider difficulties but as a standalone risk factor. Addressing adolescent sleep issues could therefore play a vital role in preventing suicide attempts.
Main findings from the study:
- Shorter total time in bed on school days and more frequent night awakenings at age 14 were associated with a higher likelihood of reporting a suicide attempt by age 17.
- These associations persisted after adjusting for established risk factors, including socioeconomic status, prior self-harm, and mental health problems.
- Measures of sleep quantity and fragmentation were stronger predictors than depressive symptoms and several other psychosocial risk indicators.
This research is the first large-scale, longitudinal study to investigate whether cognitive factors—specifically decision-making and risk-taking—affect the relationship between sleep problems and suicide attempts. Using the Cambridge Gambling Task to assess decision-making at age 14, the team found that stronger rational decision-making skills appeared to buffer the effect of night awakenings on later suicide risk. However, the protective effect of rational decision-making diminished under chronic sleep disruption, suggesting that persistent poor sleep can undermine cognitive defenses.
Senior author Professor Nicole Tang, Director of the Warwick Sleep and Pain Lab, warned that sleep deprivation and fragmentation are not trivial complaints. She explained that chronic poor sleep can erode psychological resilience and increase the likelihood of dangerous behaviours. Identifying and supporting adolescents with sleep problems could therefore reduce the number of suicide attempts.
While insufficient sleep likely contributes to impaired cognitive functioning such as worse decision-making, the authors note that additional research is required to fully map the mechanisms that link sleep disturbance to suicidal behaviour. Still, the findings point to clear, actionable prevention opportunities—most notably increasing sleep time on school nights and addressing nocturnal awakenings.
Study Details
- The analysis used data from waves 6 and 7 of the Millennium Cohort Study, covering participants at ages 14 and 17 (n = 8,524).
- Sleep measures included time in bed on school and non-school nights, sleep onset latency, frequency of night awakenings, and social jetlag.
- Outcome: self-reported suicide attempt at age 17.
- Decision-making and risk-taking were assessed with the Cambridge Gambling Task at age 14.
- Paper title: Sleep Problems, Decision-Making, and Suicide Attempts During Adolescence: A Longitudinal Birth Cohort Study. DOI: 10.1093/sleepadvances/zpaf062
Support and resources
If you or someone you know has been affected by the issues discussed in this report and needs support: children and young people can contact YoungMinds for information and details of local services (www.youngminds.org.uk/find-help) or call Childline on 0800 1111. Adults concerned about themselves or others can find NHS urgent mental health helplines and details of charities and support groups via NHS resources (www.nhs.uk/conditions/stress-anxiety-depression/mental-health-helplines/) or contact Samaritans on 116 123.
About the Millennium Cohort Study (MCS)
The Millennium Cohort Study follows over 19,500 children born in the UK in 2000–01, providing a detailed, longitudinal picture of this generation. The MCS is funded by the Economic and Social Research Council and government partners and is managed by the UCL Centre for Longitudinal Studies.
Key questions answered
Q: How does poor sleep affect suicide risk in teenagers?
A: Disrupted or insufficient sleep undermines emotional regulation and decision-making, increasing vulnerability to suicidal behaviour during adolescence.
Q: Does sleep matter more than other mental health factors?
A: In this study, sleep problems were stronger predictors of later suicide attempts than depressive symptoms or several psychosocial difficulties, and their effect remained significant after accounting for those factors.
Q: Can improving teen sleep reduce suicide rates?
A: The researchers suggest that promoting better sleep hygiene and identifying adolescents with chronic sleep disruption could become important components of suicide prevention strategies.
About this research news
Author: Matt Higgs
Source: University of Warwick
Contact: Matt Higgs, University of Warwick
Image credit: Neuroscience News
Original research: Open access. “Sleep Problems, Decision-Making, and Suicide Attempts During Adolescence: A Longitudinal Birth Cohort Study” by Michaela Pawley et al., published in SLEEP Advances. DOI: 10.1093/sleepadvances/zpaf062
Abstract
Study objectives
Sleep problems have been linked to suicidal thoughts and behaviours during adolescence, but longitudinal studies that probe contributing mechanisms—such as cognitive functioning—are scarce. This study examines whether sleep problems at 14 predict later reported suicide attempts at 17 and whether risk-taking and decision-making moderate that relationship.
Methods
Data came from waves 6 (age 14) and 7 (age 17) of the Millennium Cohort Study (n = 8,524). Self-reported sleep items at 14 were used to calculate total time in bed on school and non-school nights, social jetlag, sleep onset latency, and night awakening frequency. Suicide attempt was self-reported at 17. Decision-making and risk-taking were measured with the Cambridge Gambling Task at 14.
Results
Shorter time in bed on school nights and more frequent night awakenings at age 14 were prospectively associated with self-reported suicide attempts at 17, even when controlling for demographic and clinical covariates. Rational decision-making moderated the link between night awakenings and attempted suicide, indicating that cognitive strengths can offer some protection but may be undermined by chronic sleep disruption.
Conclusions
Reduced time in bed and fragmented sleep increase suicide risk during adolescence, and the relationship between night awakenings and attempted suicide is influenced by rational decision-making. These findings improve understanding of adolescent suicidal behaviour and identify sleep deprivation and fragmentation as potential targets for prevention.