A rapidly expanding body of literature demonstrates that
sleep disturbance is a significant risk factor for suicidal
ideation and suicidal behavior.1–9 Insomnia is associated
with suicidal ideation among patients with depression, alcohol
misuse or dependence, and posttraumatic stress disorder.1,2,10–13
The link between insomnia and suicide is evident
across the life span, including adolescents and older adulthood.4,14
Two large population-based studies have shown that
sleep disturbance, and insomnia specifically, are risk factors
for suicide death.15,16
Veterans account for an estimated 20% of suicide deaths in
the United States,17 suggesting compelling need for effective
strategies to reduce suicide mortality incidence in this population.
Two studies have demonstrated the link between insomnia
and suicidal ideation in Veterans,1,2 and a third indicated that
sleep disturbance is a stronger predictor of suicidal ideation
and suicidal behavior among active military personnel than two