title: Sleep disturbance preceding suicide among veterans.
abstract: OBJECTIVE
  We examined the role of sleep disturbance in time to suicide since the last treatment visit among veterans receiving Veterans Health Administration (VHA) services.
  
  
  METHODS
  Among 423 veteran suicide decedents from 2 geographic areas, systematic chart reviews were conducted on the 381 (90.1%) who had a VHA visit in the last year of life. Veteran suicides with a documented sleep disturbance (45.4%) were compared with those without sleep disturbance (54.6%) on time to death since their last VHA visit using an accelerated failure time model.
  
  
  RESULTS
  Veterans with sleep disturbance died sooner after their last visit than did those without sleep disturbance, after we adjusted for the presence of mental health or substance use symptoms, age, and region.
  
  
  CONCLUSIONS
  Findings indicated that sleep disturbance was associated with time to suicide in this sample of veterans who died by suicide. The findings had implications for using the presence of sleep disturbance to detect near-term risk for suicide and suggested that sleep disturbance might provide an important intervention target for a subgroup of at-risk veterans.
authors.affiliation: VISN 2 Center of Excellence for Suicide Prevention, Canandaigua Veteran Affairs Medical Center, Canandaigua, NY 14424, USA. Wilfred_pigeon@urmc.rochester.edu
authors.forename: Wilfred R
authors.initials: WR
authors.lastname: Pigeon
authors.forename: Peter C
authors.initials: PC
authors.lastname: Britton
authors.forename: Mark A
authors.initials: MA
authors.lastname: Ilgen
authors.forename: Ben
authors.initials: B
authors.lastname: Chapman
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Conner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012042:Registries; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000523:psychology*; D013405:Suicide / Q000706:statistics & numerical data*; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology*