Onset insomnia and insufficient sleep duration are associated with suicide ideation in university students and athletes.

BACKGROUND: Previous work has shown that poor sleep is a prospective risk factor for suicide in clinical populations and might contribute to risk in the general population. The present study evaluated whether sleep distress, onset insomnia, and insufficient sleep are associated with suicide ideation in university students and athletes participating in the 2011-2014 National College Health Assessment (NCHA; n = 113,185). METHODS: In the NCHA survey, students self-reported the presence or absence of suicide ideation within the past 12 months. SLEEP DISTRESS was assessed with an item indicating that "sleep difficulties" were "particularly traumatic or difficult to handle." ONSET INSOMNIA was assessed as at least 3 nights per week where survey participants reported an "extremely hard time falling asleep." INSUFFICIENT SLEEP was operationalized as the number of days per week where the participants felt they did not get "enough sleep to feel rested." All variables were yes/no except INSUFFICIENT SLEEP, which was categorized as 0-1 (reference), 2-3, 4-5, or 6-7 nights. Binary logistic regression analyses examined suicide ideation as the outcome and sleep variable as a predictor, adjusted for age, sex, year in school, recent depressed mood, and survey year. Associations within student-athletes were likewise assessed. RESULTS: 7.4% of students reported suicide ideation within the past 12 months. In adjusted models, this was significantly associated with SLEEP DISTRESS (OR = 3.01, 95% CI [2.86, 3.16], p < 0.0001), ONSET INSOMNIA (OR = 1.95, 95% CI [1.86, 2.04], p < 0.0001), as well as INSUFFICIENT SLEEP (4-5 nights, OR = 1.41, 95% CI [1.28, 1.56], p < 0.0001; 6-7 nights, OR = 1.92, 95% CI [1.74, 2.13], p < 0.0001). Although suicide ideation was less common among athletes, ORs were similar for athletes for all sleep variables of interest. CONCLUSION: Sleep distress, onset insomnia, and insufficient sleep were all strongly related to suicide ideation among university students. These relationships were the same among collegiate athletes, even though this group reported less overall suicide ideation. Our findings suggest that university students may benefit from educational materials linking sleep disruption to maladaptive thinking and suicide ideation.

Sleep and Health Among Collegiate Student Athletes.

Although the link between sleep, health, and performance has been well documented, research on this link in collegiate student athletes is still in its infancy. A large body of evidence indicates that collegiate student athletes are not obtaining enough sleep, but less is known about their sleep quality, patterns, and the impact on health and performance. Consequently, short sleep negatively affects physical and mental health, as well as several domains of performance (ie, aerobic, anaerobic, sport-specific, cognitive). The majority of studies examining the links between short sleep, health, and performance have been conducted with healthy adults or noncollegiate athlete samples; however, collegiate student athletes have demands unlike those of their nonathlete or noncollegiate athlete counterparts. Poor sleep health and sleep disorders are of increasing concern among the college athlete population and have recently been recognized by national and international sports governing bodies. The purpose of this review is to summarize the available literature on sleep and its impact on health and performance among athletes, specifically addressing gaps where little to no data is available on collegiate student athletes. Consideration is also given to evidence-based sleep interventions that have been utilized with athletes, as well as recommendations for future research and intervention development.