Patients with sleep disorders have a significant increase in suicidal ideation and suicide attempts, at the assessment and lifetime (Goodwin et al, 2008; Chellappa et al, 2007; Wojnar et al, 2009; Li et al, 2010).

To evaluate the relationship between sleep disorders and suicidal behavior.

To study factors associated with a diagnosis of insomnia in patients admitted to the Emergency Department.

Participants were 843 patients consecutively admitted to the Emergency Department of the Sant’Andrea University Hospital in Rome, Italy, between January and December 2010. All patients admitted were referred to a psychiatrist. A clinical interview based on the MINI and a semi structured interview were performed. Patients were asked about “ongoing” suicidal ideation or plans for suicide. Clinical diagnoses were assigned according to ICD-10 criteria.

48% received a diagnosis of a mood disorders (BD and MDD) or anxiety disorders, 17.1% Schizophrenia or other non-affective psychosis. Patients with insomnia had more frequently a diagnosis of BD (23.9% vs. 12.4%) or MDD (13.3% vs. 9.5%; P< 0.001). Patients with insomnia less frequently had attempted suicide in the past 24 hours (5.3% vs. 9.5%; P< 0.05) than other patients, but suicide attempters with insomnia more frequently used violent methods (64.3% vs. 23.6%; P< 0.01) than suicide attempters without insomnia.

Our results support a relationship between sleep disorders and suicidal behavior. Clinicians should pay attention to sleep disorders when assessing suicide attempters; in fact, such conditions may have important clinical implications.