title: Sleep and suicide: an analysis of a cohort of 394,000 Taiwanese adults.
abstract: BACKGROUND
  Sleep problems may lead to, or be symptomatic of, depression and other mental illnesses yet few studies have investigated their association with suicide risk.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Taiwan.
  
  
  METHODS
  393,983 men and women aged 20 or above participating in the MJ health check-up programme.
  
  
  RESULTS
  There were 335 suicides over a mean of 7.4 years follow-up. There was a reverse J-shaped association between sleep duration and suicide risk. When compared with those sleeping 6-8 h per night the adjusted hazard ratios (95% confidence intervals) for suicide associated with 0-4, 4-6 and >8 h sleep were 3.5 (2.0-6.1), 1.5 (1.1-1.9) and 1.5 (1.1-2.0), respectively. People requiring sleeping pills to get to sleep (1.2% participants) were at over 11-fold increased risk; difficulty falling asleep (11.5% participants), frequent dreaming (16.7%) and being easily awoken (30.6%) were associated with a 2.0-, 1.6- and 1.3-fold increased risk of suicide, respectively.
  
  
  CONCLUSIONS
  Less than 6 h sleep duration, sleep disturbances and reported use of sleep medicines are markers of suicide risk. Sleep problems should be assessed when evaluating suicide risk.
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, UK. D.J.Gunnell@bristol.ac.uk
authors.forename: David
authors.initials: D
authors.lastname: Gunnell
authors.forename: Shu-Sen
authors.initials: SS
authors.lastname: Chang
authors.forename: Min Kuang
authors.initials: MK
authors.lastname: Tsai
authors.forename: Chwen Keng
authors.initials: CK
authors.lastname: Tsao
authors.forename: Chi Pang
authors.initials: CP
authors.lastname: Wen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012890:Sleep; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000523:psychology*; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013624:Taiwan
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