Age-Specific Association Between Sleep Health and Suicidal Thoughts: A Large Scale Cross Sectional Study

Sleep health is a key factor influencing mental and physical well-being. Existing research has predominantly focused on the relationship between single sleep problems and suicidal thoughts, lacking a comprehensive investigation from the perspectives of multidimensional sleep health and the life course.

This study aimed to utilize a large-scale sample to explore the association between multidimensional sleep health and suicidal thoughts, and to examine the moderating role of age in this relationship.

Using data from 35,502 Chinese adults, we assessed multiple sleep dimensions and suicidal thoughts via self-report. Analyses included linear regression, Canonical Correlation Analysis (CCA), and moderation tests.

Regression analyses showed that, after controlling for covariates, poorer sleep health was significantly associated with a higher future suicide likelihood. Canonical Correlation Analysis further revealed a significant multivariate association between patterns of sleep health and patterns of suicidal behavior, primarily driven by insomnia and sleep variability. Moderation analysis indicated that age significantly moderated the relationship between sleep variability and suicidal thoughts; this association was strongest among young adults, followed by middle-aged adults, and weakest in older adults. Stratified Canonical Correlation Analysis also showed that the overall strength of the sleep-suicide association decreased with increasing age.

Multidimensional sleep health, particularly insomnia and sleep variability, is a significant correlate of suicidal thoughts. The association is age-specific, highlighting the need for developmentally tailored, sleep-focused interventions.