Smartphone-Measured Sleep Health Risk Factors Detect Suicidal Thoughts and Behaviors Among Adolescents. Kirshenbaum, J. S., Pagliaccio, D., Trivedi, E., Galfalvy, H., Joyce, K. J., Durham, K., Porta, G., Bloom, P. A., Tse, T. C., Blanchard, A., Chernick, L. S., Crowley, R. N., Dayan, P. S., Kahn, L. E., Zelazny, J., Brent, D. A., Allen, N. B., & Auerbach, R. P. JAACAP Open, June, 2026.
Smartphone-Measured Sleep Health Risk Factors Detect Suicidal Thoughts and Behaviors Among Adolescents [link]Paper  doi  abstract   bibtex   
Objective Suicide deaths and poor sleep health in adolescents have significantly increased. Smartphone sensors (e.g., accelerometry) provide an unobtrusive and scalable way to monitor sleep health over extended time periods. We hypothesized that poor weekly sleep health (i.e., shorter and variable time-in-bed; late and variable bedtime) assessed through smartphone sensors will associate with weekly suicidal thoughts and behaviors (STB). Method High-risk adolescents (N=145, 13-18-years-old, 112 female) oversampled for STB (n=114) installed the Effortless Assessment Research System application on their smartphones, allowing access to motion data over 6 months. Simultaneously, the app measured weekly suicidal ideation. Clinical interviews measured suicidal events (i.e., attempts, specifc psychiatric hospitalizations and emergency department events related to suicide risk) at 1-, 3-, and 6-month follow-up assessments. Mixed-effects logistic regression models tested whether the weekly average and variability of time-in-bed and bedtime related to next-week STB. Results A 1 standard deviation increase in weekly time-in-bed, relative to one’s typical weekly time-in-bed, related to a near 2-folds greater odds of a next-week suicidal event (OR=1.85, 95% CI [1.01, 3.28], p=.045). This was driven by time-in-bed on weekdays (OR=2.39, 95% CI [1.19, 4.44], p=.013). Greater variability of bedtimes (i.e., lower bedtime consistency) within a weekend, relative to one’s own typical weekend bedtime variability, predicted next-week suicidal ideation (OR=1.91, 95% CI [1.28, 2.69], p=0.001). Conclusion Results reveal proximal associations between smartphone-derived sleep measures and STB, highlighting the possibility of developing just-in-time interventions, focusing on which sleep behaviors to modify and when to intervene to reduce suicide risk.
@article{kirshenbaum_smartphone-measured_2026,
	title = {Smartphone-{Measured} {Sleep} {Health} {Risk} {Factors} {Detect} {Suicidal} {Thoughts} and {Behaviors} {Among} {Adolescents}},
	issn = {2949-7329},
	url = {https://www.sciencedirect.com/science/article/pii/S2949732926000578},
	doi = {10.1016/j.jaacop.2026.06.001},
	abstract = {Objective
Suicide deaths and poor sleep health in adolescents have significantly increased. Smartphone sensors (e.g., accelerometry) provide an unobtrusive and scalable way to monitor sleep health over extended time periods. We hypothesized that poor weekly sleep health (i.e., shorter and variable time-in-bed; late and variable bedtime) assessed through smartphone sensors will associate with weekly suicidal thoughts and behaviors (STB).
Method
High-risk adolescents (N=145, 13-18-years-old, 112 female) oversampled for STB (n=114) installed the Effortless Assessment Research System application on their smartphones, allowing access to motion data over 6 months. Simultaneously, the app measured weekly suicidal ideation. Clinical interviews measured suicidal events (i.e., attempts, specifc psychiatric hospitalizations and emergency department events related to suicide risk) at 1-, 3-, and 6-month follow-up assessments. Mixed-effects logistic regression models tested whether the weekly average and variability of time-in-bed and bedtime related to next-week STB.
Results
A 1 standard deviation increase in weekly time-in-bed, relative to one’s typical weekly time-in-bed, related to a near 2-folds greater odds of a next-week suicidal event (OR=1.85, 95\% CI [1.01, 3.28], p=.045). This was driven by time-in-bed on weekdays (OR=2.39, 95\% CI [1.19, 4.44], p=.013). Greater variability of bedtimes (i.e., lower bedtime consistency) within a weekend, relative to one’s own typical weekend bedtime variability, predicted next-week suicidal ideation (OR=1.91, 95\% CI [1.28, 2.69], p=0.001).
Conclusion
Results reveal proximal associations between smartphone-derived sleep measures and STB, highlighting the possibility of developing just-in-time interventions, focusing on which sleep behaviors to modify and when to intervene to reduce suicide risk.},
	urldate = {2026-06-08},
	journal = {JAACAP Open},
	author = {Kirshenbaum, Jaclyn S. and Pagliaccio, David and Trivedi, Esha and Galfalvy, Hanga and Joyce, Karla J. and Durham, Katherine and Porta, Giovanna and Bloom, Paul A. and Tse, Trinity C. and Blanchard, Ashley and Chernick, Lauren S. and Crowley, Ryann N. and Dayan, Peter S. and Kahn, Lauren E. and Zelazny, Jamie and Brent, David A. and Allen, Nicholas B. and Auerbach, Randy P.},
	month = jun,
	year = {2026},
	keywords = {suicidal ideation, youth, experience sampling methodology, mobile sensors, suicidal events},
	file = {ScienceDirect Snapshot:/Users/mexico/Zotero/storage/L4YUD5T8/S2949732926000578.html:text/html},
}
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