@article{ref1,
title="Sleep and suicide: an analysis of a cohort of 394,000 Taiwanese adults",
journal="Social psychiatry and psychiatric epidemiology",
year="2013",
author="Gunnell, David and Chang, Shu-Sen and Tsai, Min Kuang and Tsao, Chwen Keng and Wen, Chi Pang",
volume="48",
number="9",
pages="1457-1465",
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. DESIGN: Prospective cohort study. SETTING: Taiwan. PARTICIPANTS: 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.<p /> <p>Language: en</p>",
language="en",
issn="0933-7954",
doi="10.1007/s00127-013-0675-1",
url="http://dx.doi.org/10.1007/s00127-013-0675-1"
}