A Prospective Study of Sleep Health and Suicidal Behavior

Sleep is closely tied to emotional functioning, and disruptions in sleep are common among adolescents experiencing depression and suicidal thoughts and behaviors (STB). There is growing evidence that sleep problems may play a role in maintaining or worsening mental health over time. In particular, shorter sleep may increase sensitivity to daily stressors, especially in interpersonal contexts, which are especially prominent during adolescence. Understanding how nightly changes in sleep influence next-day mood and reactivity may help clarify one way in which suicide risk is sustained in youth with suicidal thoughts and behavior and provide a helpful focus area for treatment.

Dr. Tina R. Goldstein used her AFSP-funded grant to study 198 adolescents and young adults receiving intensive treatment for depression and suicide risk, collecting daily sleep, mood, and interpersonal data over an average of two months. Participants wore actigraphy devices to measure sleep and completed daily surveys assessing depression severity and emotional responses to interpersonal events. Dr. Goldstein found that sleeping less than usual was associated with greater next-day depression, particularly among those with more severe depression. Shorter sleep was also linked to increased negative emotional reactivity to interpersonal stressors, such as conflict or feeling excluded. This heightened reactivity helped explain the connection between sleep loss and worsening depression. This same relationship between sleep and emotional reactivity has been linked to increases in suicidal ideation, suggesting that sleep loss may contribute to suicide risk, in part by amplifying negative emotional responses to daily experiences. Over the course of treatment, self-reported sleep increased and depression improved, but objective sleep measures did not show the same change, pointing to the complexity of people’s perceptions of their own sleep experience, versus how it is measured. Overall, the findings suggest that it’s important to measure sleep, both objectively and experientially.

Citation: Wescott, D. L., Goldstein, T. R., Hijazi, J., Rice, D., Rode, N., Poling, K., Zelazny, J., Brent, D., & Franzen, P. L. (2026). Sleeping Less Than Usual is Associated With Greater Daily Depression and Higher Reactivity to Negative Interpersonal Events Among Suicidal Adolescents. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, S1054-139X(26)00065-0. Advance online publication. https://doi.org/10.1016/j.jadohealth.2026.02.00900065-0/fulltext)