Purpose: To investigate sleep quantity as a moderator of vaping and self-reported suicidality among adolescents.
Design: Cross-sectional. Setting: United States high schools.
Sample: 10,520 high-school students with complete data on the primary outcome of suicide attempt in the past year (76.9% response rate).
Measures: 2019 Youth Risk Behaviors Survey.
Analysis: Logistic regression to examine main effects and potential moderation.
Results: Students with under seven sleep hours on school nights (OR = 2.6; 95% CI = 2.1-3.3) and who vaped in the past month (OR = 3.0; 95% CI = 2.1-3.9) had higher odds of attempting suicide in the last year. Sleep quantity moderated the relationship between vaping and suicidal thoughts in the past year (P = .01) but did not moderate the relationship between vaping and a suicide plan (P = .15) or suicide attempts (P = .06). Specifically, vaping had a smaller effect on suicidal thoughts among students who slept under seven hours on school nights (OR = 1.8) compared to the descriptively larger effect among participants with more sleep (OR = 2.5).
Conclusions: Students who vape or report low sleep quantity would be ideal participants in suicide prevention interventions as they may be at higher risk for suicidality. Organizations implementing sleep or vaping interventions should incorporate information regarding the higher odds of suicide among students with low sleep quantity or vaping habits.
Keywords: adolescent; sleep quantity; suicide; vaping.