Sleep problems and self-harm in adolescence

Background: Although self-harm and sleep problems are major public health problems in adolescence, detailed epidemiological assessment is essential to understand the nature of this relationship. Aims: To conduct a detailed assessment of the relationship between sleep and self-harm in adolescence. Method: A large population-based study in Norway surveyed 10 220 adolescents aged 16–19 years on mental health, including a comprehensive assessment of sleep and self-harm. Results: Adolescents with sleep problems were significantly more likely to report self-harm than those without sleep problems. Insomnia, short sleep duration, long sleep onset latency, wake after sleep on set as well as large differences between weekdays versus weekends, yielded higher odds of self-harm consistent with a dose–response relationship. Depressive symptoms accounted for some, but not all, of this association. Conclusions: The findings highlight a strong relationship between sleep problems and self-harm. Interventions to reduce adolescent self-harm ought to incorporate sleep problems as a treatment target