ArticleThe journal of climate change and health
The influence of temperature on suicidality in youth: The role of insomnia.
Article in The journal of climate change and health. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Suicide is the second leading cause of death among youth, with growing evidence linking higher ambient temperatures to increased suicidality - a concerning trend as global temperatures rise. Sleep disruption is a theorized mechanism, though clinical evidence is lacking. Materials and methods: We performed a cross-sectional analysis of 5,590 pediatric patients (3-18 years) presenting to a psychiatric emergency department with and without suicidality (December 2018-March 2023). Seven-day averages of mean and minimum daily ambient temperatures and precipitation were obtained at home addresses from the PRISM Climate Group dataset. Logistic regression assessed insomnia as a moderator and mediator of the temperature-suicidality relationship, controlling for sociodemographic, diagnostic, and environmental variables. Negative controls included modeling suicidality using hypersomnia-temperature and insomnia-precipitation interactions. Results: Mean and minimum daily temperatures moderated the temperature-suicidality relationship only in those with insomnia (Mean Temperature: RR: 1.06 per 5°C [95% CI 1.01-1.06], p = 0.015; Minimum Temperature: RR: 1.06 per 5°C [95% CI 1.01-1.06], p = 0.010). Minimum temperature, a proxy for nighttime temperature, was associated with suicidality through insomnia in a mediation model (Indirect Pathway: OR: 1.05 [95% CI 1.00-1.11], p = 0.045), though mean temperature was not. No significant moderation occurred modeling suicidality with hypersomnia-temperature or insomnia-precipitation interactions. Conclusion: This is the first clinical evidence that insomnia influences the heat-suicidality relationship in youth. Limitations include cross-sectional data that cannot establish temporal directionality of associations, heterogeneous suicidality outcomes, self-reported sleep data, and pandemic-era data collection. Larger mechanistic analyses of temperature, sleep, and suicidality are needed to understand climatic mental health impacts and develop interventions.
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