Background Suicide is a leading cause of death among adolescents. A number of studies indicate that sleep quality, mental health status and excessive Internet use are associated with suicide risk in this population, but less Longitudinal study is known to explore the associations of sleep disturbance, depression and problematic Internet use with subsequent suicide ideation among school adolescents in China. The aim of this study was to examine the associations between suicidal ideation and sleep disturbance, depression and problematic Internet use.

Methods 1700 individuals which covered the school-aged adolescents from southeastern Chinese areas with self-administered questionnaires were screened in 2012, and a follow-up survey was conducted in June 2015. Information was collected on socio-demographics and suicide ideation, planning and attempts in the past year, sleep quality, mental health status and problematic Internet use were separately assessed with PSQI, CESD-10 and IAT. Multivariate logistic regression analyses, controlling for confounding factors, were conducted to explore the associations of sleep quality, depression, problematic Internet use with suicide ideation.

Results Among the participants, 15.5% of adolescents had the suicide ideation in past year. After controlling for baseline suicide and other confounding factors, adolescents with sleep disturbance in 2012 had a higher tendency to subsequent suicide ideation in 2015 compared with those who had no sleep disturbance (OR: 5.11; 95% CI: 2.46–10.64). Suicidal ideation was highly associated with psychiatric disorders such as depression (OR: 3.57; 95% CI: 1.45–8.22), problematic Internet use also significantly predicted suicide ideation in 2015 (OR: 2.62; 95% CI: 1.26–5.45).

Conclusions Preventing and mitigating adolescents’ sleep disturbance, depression and controlling Internet use reasonably have the potentials to reduce suicide occurrence. Among adolescents already exposed to adversities, effective psychological intervening services which may be against future suicide behaviours, should be formulated according to the different needs of each individual. We also suggest that more consideration from parents and teachers should be given to young adolescents to support their sleep quality and good mental health status to reduce the potential risk factors of increased suicide rates.