Sleep Problems, Suicidality and Depression among American Indian Youth

Abstract

Study background Mental health and sleep problems are important public health concerns among adolescents yet little is known about the relationship between sleep, depressive symptoms, and suicidality among American Indian youth. Methods This study examined the impact of sleep and other factors on depressive symptoms and suicidality among Lumbee American Indian adolescents (N=80) ages 11–18. Results At the bivariate level, sleepiness, was associated with depression but not with suicidality. Time in bed (TIB) was not associated with depression, but more TIB decreased the likelihood of suicidality. Higher levels of depressive symptoms were associated with increased likelihood of suicidality. At the multivariate level, sleepiness, suicidality, and self-esteem were associated with depression. TIB and depressive symptoms were the only variables associated with suicidality. Conclusion In working with American Indian youth, it may be helpful to consider sleep patterns as part of a comprehensive assessment process for youth who have or are at risk for depression and suicide.

A Narrative Review of the Literature on Insufficient Sleep, Insomnia, and Health Correlates in American Indian/Alaska Native Populations

“…Table 1 presents a summary of sample descriptions, prevalence and correlates of insufficient sleep and insomnia, the measures used, and author recommendations for the 12 articles included in this review. The limited research literature focused on the following aspects of insufficient sleep and insomnia: (1) prevalence [20, 46–52], (2) demographic and cultural correlates [20, 46, 48–50, 53–55], (3) medical and mental health correlates and predictors [46–53, 55], and (4) theoretical mechanisms for the insufficient sleep-culture-chronic disease relationships [47–49].…”

“…Insufficient sleep and insomnia also had differences in associations between depression and suicide: a study of 80 AI adolescents found less time in bed to be associated with increased odds of self-reported suicidality but not depression among AI adolescents [55]. A dissertation study using a sample of 232 students, ages 12–21, found insomnia to be a predictor of depression but not suicidal ideation or suicide attempts among AI/AN youth [52].…”

“…Additional author recommendations for research and practice based on the current review can be seen in Table 1. These recommendations include longitudinal research studies to determine the nature of the associations among sleep, mental and physical health, and sociocultural factors [46], the use of CBT-I and psychoeducation to address sleep problems among AI/ANs [48], and addressing sleep in AI/ANs with psychiatric [55] or chronic health problems [49] (see Table 1 for a detailed list of recommendations by study).…”

Lessons Learned From a Community-Based Participatory Research Mental Health Promotion Program for American Indian Youth

“…Although not statistically significant, participants with regular attendance (at least two thirds of classes) showed a decrease in suicidal ideation and increase in protective factors. Significant findings are limited due to the small sample size and lack of randomization; topical results on bullying (Bell et al, 2014) and depression and nonsuicidal self-harm (Arnold et al, 2013) are presented elsewhere. Culture class evaluation data supported program importance and was used by the tribe to support the continuing need for youth-focused programs.…”

Poor self-reported sleep quality associated with suicide risk in a community sample of American Indian adults

“…However, sleep has not been systematically evaluated in association with suicide risk specifically among AI/AN adults. In one study of AI youth, more time in bed was found to be associated with suicidality and depressive symptoms [ 23 ].…”