Role of sleep quality in mediating the relationship between sexual minority status and suicidal behavior among Chinese adolescents.

BACKGROUND

Studies suggest that sexual minority adolescents experience higher rates of sleep disturbance than their heterosexual peers, and disturbed sleep is a well-known risk factor for suicidality. This study aimed to explore whether sleep quality had mediating effects on the relationship between sexual minority status and suicidal behavior in Chinese adolescents.

METHODS

We analyzed data collected from 7th to 12th graders from seven randomly selected provinces of People's Republic of China in the 2015 School-Based Chinese Adolescents Health Survey. The 123,459 students who completed questionnaires regarding sexual attraction, the Pittsburgh Sleep Quality Index, past-year suicidal ideation, and past-year suicide attempts were included in our study (response rate: 95.9%).

RESULTS

After adjustment for covariates, sexual minority status was associated with suicidal ideation (adjusted odds ratio =1.82, 95% CI=1.69-1.95) and suicide attempts (adjusted odds ratio =2.16, 95% CI=1.82-2.56). Sleep quality partially mediated the effects of sexual minority status on suicidal ideation (standardized β estimate=0.009, 95% CI=0.007-0.012) and suicide attempts (standardized β estimate=0.004, 95% CI=0.003-0.005).

CONCLUSION

Poor sleep quality partially explained the increased risk of suicidality for Chinese sexual minority adolescents. To prevent subsequent suicidality, suicide interventions targeting sexual minorities should be made, with a focus on their disparities in sleep disturbance and sleep health promotion.