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Baldini V, Gnazzo M, Rapelli G, Marchi M, Pingani L, Ferrari S, De Ronchi D, Varallo G, Starace F, Franceschini C, Musetti A, Poletti M, Ostuzzi G, Pizza F, Galeazzi GM, Plazzi G. Association between sleep disturbances and suicidal behavior in adolescents: a systematic review and meta-analysis. Front Psychiatry 2024; 15:1341686. [PMID: 39421072 PMCID: PMC11483864 DOI: 10.3389/fpsyt.2024.1341686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 09/11/2024] [Indexed: 10/19/2024] Open
Abstract
Introduction Adolescents' health and well-being are seriously threatened by suicidal behaviors, which have become a severe social issue worldwide. Suicide is one of the leading causes of mortality for adolescents in low and middle-income countries, with approximately 67,000 teenagers committing suicide yearly. Although an association between sleep disturbances (SDs) and suicidal behaviors has been suggested, data are still scattered and inconclusive. Therefore, to further investigate this association, we conducted a meta-analysis to verify if there is a link between SDs and suicidal behaviors in adolescents without diagnosed psychiatric disorders. Methods PubMed, CENTRAL, EMBASE, and PsycINFO were searched from inception to August 30th, 2024. We included studies reporting the estimation of suicidal behaviors in adolescents from 12 to 21 years of age, with SDs and healthy controls. The meta-analysis was based on odds ratio (OR, with a 95% confidence interval ([CI]), estimates through inverse variance models with random-effects. Results The final selection consisted of 19 eligible studies from 9 countries, corresponding to 628,525 adolescents with SDs and 567,746 controls. We found that adolescents with SDs are more likely to attempt suicide (OR: 3.10; [95% CI: 2.43; 3.95]) and experience suicidal ideation (OR: 2.28; [95% CI 1.76; 2.94]) than controls. Conclusion This meta-analysis suggests that SDs are an important risk factor for suicidal ideation and suicide attempts in healthy adolescents. The findings highlight the importance of early identification of SDs to prevent suicidal behaviors in this population. Systematic review registration PROSPERO, identifier CRD42023415526.
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Affiliation(s)
- Valentina Baldini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena and Reggio Emilia, Italy
| | - Martina Gnazzo
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena and Reggio Emilia, Italy
| | - Giada Rapelli
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Mattia Marchi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena and Reggio Emilia, Italy
| | - Luca Pingani
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena and Reggio Emilia, Italy
- Dipartimento ad Attività Integrate di Salute Mentale e Dipendenze Patologiche, Azienda Unità Sanitaria Locale (USL) IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Silvia Ferrari
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena and Reggio Emilia, Italy
- Dipartimento ad Attività Integrate di Salute Mentale e Dipendenze Patologiche, Azienda Unità Sanitaria Locale (USL) IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Diana De Ronchi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giorgia Varallo
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena and Reggio Emilia, Italy
| | - Fabrizio Starace
- Department of Mental Health and Dependence, AUSL of Modena, Modena, Italy
| | | | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
| | - Michele Poletti
- Department of Mental Health and Pathological Addiction, Child and Adolescent Neuropsychiatry Service, Azienda Unità Sanitaria Locale (USL)-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Giovanni Ostuzzi
- World Health Organiization (WHO) Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, Verona, Italy
| | - Fabio Pizza
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Gian Maria Galeazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena and Reggio Emilia, Italy
- Dipartimento ad Attività Integrate di Salute Mentale e Dipendenze Patologiche, Azienda Unità Sanitaria Locale (USL) IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Giuseppe Plazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena and Reggio Emilia, Italy
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
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Mombelli S, Bacaro V, Curati S, Berra F, Sforza M, Castronovo V, Ferini-Strambi L, Galbiati A, Baglioni C. Non-pharmacological and melatonin interventions for pediatric sleep initiation and maintenance problems: A systematic review and network meta-analysis. Sleep Med Rev 2023; 70:101806. [PMID: 37406497 DOI: 10.1016/j.smrv.2023.101806] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/07/2023] [Accepted: 06/10/2023] [Indexed: 07/07/2023]
Abstract
Sleep initiation and maintenance problems are common in the pediatric population and while behavioral interventions are recommended, their efficacy remains to be evaluated in clinical trials. We conducted a systematic review and network meta-analysis to assess the efficacy of non-pharmacological treatments and melatonin for sleep initiation and maintenance problems in healthy pediatric populations. We included 30 studies in the systematic review and 15 in the meta-analysis. Three network meta-analyses were conducted for sleep onset latency (SOL), wake after sleep onset (WASO), and total sleep time (TST). For SOL variable, the results support greater effectiveness of light therapy and melatonin than evidence-based psychological interventions, whether implemented in combination with light therapy or not. Regarding WASO variable, evidence-based psychological interventions and a combination of those techniques plus light treatment were the most efficacious. Finally, for TST variable, a larger effect was shown for the combined treatment of evidence-based psychological intervention with light therapy in comparison to other interventions. In conclusion, we found a high variability between study protocols likely impacting the results of the meta-analysis. Future randomized control trials studies, stratified by pediatric age classes, are needed in order to provide clear suggestions in clinical settings.
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Affiliation(s)
- Samantha Mombelli
- Department of Clinical Neurosciences, Neurology-Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Valeria Bacaro
- Department of Human Sciences, University of Rome Guglielmo Marconi, Rome, Italy; Department of Psychology, University of Bologna, Bologna, Italy
| | - Sara Curati
- Department of Human Sciences, University of Rome Guglielmo Marconi, Rome, Italy
| | - Francesca Berra
- Department of Clinical Neurosciences, Neurology-Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Marco Sforza
- Department of Clinical Neurosciences, Neurology-Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Vincenza Castronovo
- Department of Clinical Neurosciences, Neurology-Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Luigi Ferini-Strambi
- Department of Clinical Neurosciences, Neurology-Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Andrea Galbiati
- Department of Clinical Neurosciences, Neurology-Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.
| | - Chiara Baglioni
- Department of Human Sciences, University of Rome Guglielmo Marconi, Rome, Italy; Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, DE, Germany; Clinic for Sleep Psychotherapy, School of Cognitive Psychotherapy, SPC, Rome, Italy
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Internet and Video Games: Causes of Behavioral Disorders in Children and Teenagers. CHILDREN (BASEL, SWITZERLAND) 2022; 10:children10010086. [PMID: 36670637 PMCID: PMC9856521 DOI: 10.3390/children10010086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/24/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023]
Abstract
Even though video games have been present among children for many years, children are using them more continuously and in an abusive and indiscriminate way nowadays because of the "technological boom". It is affecting the behavior of children and adolescents. This is the reason why we are carrying out this systematic review. The main objective of this article is to investigate literature that directly connects the continuous and undifferentiated use of video games with the emergence of behavioral disorders in children and young people. The PRISMA statement was followed in the process of this article. We used SCOPUS, Web of Science and PubMed as databases, moreover, we searched studies with a scoping review. The results indisputably supported six out of seven of our hypotheses. We find that the excessive use of video games causes addiction to technology, aggressive behaviors, sleep disorders, and poor school performance. In addition, it hinders social relationships and the development of emotional intelligence. To conclude, it is necessary to correctly use video games in particular, and technologies in general, adapting their content to children's age, as well as the amount of time that they dedicate to use them.
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Bin Eid W, Lieu AA, Neoh MJY, Al-Zoubi SM, Esposito G, Dimitriou D. Characteristics of Sleep Patterns in Adolescents: Comparisons between Saudi Arabia and the UK. Healthcare (Basel) 2022; 10:healthcare10081378. [PMID: 35893200 PMCID: PMC9332443 DOI: 10.3390/healthcare10081378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/19/2022] [Accepted: 07/21/2022] [Indexed: 11/17/2022] Open
Abstract
There are concerns regarding sleep deprivation among adolescents, especially with mounting evidence for the importance of sleep during puberty, and its effects on health and families. The present study aimed to characterise sleep in typical development (TD) adolescents in Saudi Arabia, and compare their sleep profiles to TD adolescents in the UK, to evaluate sleep patterns in adolescents in Saudi Arabia, and to examine the relationship between sleep patterns and the use of social media in both groups. Findings from the current study reported a shorter sleep duration for the Saudi Arabia group than in previous studies and the UK group, which may be attributed to the lack of sleep hygiene practised in Saudi Arabia. Multiple analysis of variance results found significant differences in daytime sleepiness (p < 0.001) and a preference for morningness/eveningness (p < 0.001) between Saudia Arabia and UK adolescents. Statistically significant negative correlations (p > 0.05) between the duration of social media usage and sleep duration were found in both the Saudi Arabia and UK adolescents, where a lower number of sleep hours was observed with a higher duration of social media use. This study fills a gap in the research of sleep in Saudi Arabia in adolescents, and offers important insights on the comparison in sleep habits between Saudi Arabia and UK adolescents.
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Affiliation(s)
- Wasmiah Bin Eid
- Sleep Education and Research Laboratory, UCL Institute of Education, 25 Woburn Square, London WC1H 0AA, UK;
| | - An An Lieu
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore 639818, Singapore; (A.A.L.); (M.J.Y.N.)
| | - Michelle Jin Yee Neoh
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore 639818, Singapore; (A.A.L.); (M.J.Y.N.)
| | | | - Gianluca Esposito
- Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy
- Correspondence: (G.E.); (D.D.)
| | - Dagmara Dimitriou
- Sleep Education and Research Laboratory, UCL Institute of Education, 25 Woburn Square, London WC1H 0AA, UK;
- Correspondence: (G.E.); (D.D.)
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An Exploratory Analysis of the Effect of Demographic Features on Sleeping Patterns and Academic Stress in Adolescents in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127032. [PMID: 35742281 PMCID: PMC9222687 DOI: 10.3390/ijerph19127032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/04/2022] [Accepted: 06/07/2022] [Indexed: 12/10/2022]
Abstract
Adolescents typically engage in unhealthy lifestyle habits including short sleep and high academic stress. These in turn may have serious impacts on their development. The present study examines the effect of demographic characteristics on sleep patterns and academic stress in adolescents. A sample of 244 (119 females) junior high school adolescents aged between 11 and 16 were recruited from China. The Student Life Stress Questionnaire and the School Sleep Habits Survey were used to assess participants' sleep habits and academic stress. Multipair and corrected pairwise Kruskal-Wallis tests were conducted to assess the effect of school grade, gender, academic performance level, living situation, single child status, and parental education on adolescents' sleeping patterns and academic stress. Significant changes in facets of sleeping patterns emerged when examining groups of students in terms of school grade, living situation, and single-child status. Furthermore, caffeine consumption was found to be significantly higher in males, in students with poorer academic performances, and in single-child adolescents. Ultimately, academic stress was modulated by adolescents' school grade, academic performances, living situation, and single-child status. Developmental trajectories in sleep patterns together with differential exposure to stressors and adopted coping mechanisms are discussed in the manuscript.
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