Sleep and Suicide Risk: A Perspective on Integrating Sleep into Routine Psychiatric Assessment

Suicide remains one of the leading causes of death worldwide, yet psychiatry continues to assess risk primarily through suicidal ideation. This narrow focus overlooks a critical factor: sleep. A growing body of evidence demonstrates that insomnia, nightmares, and circadian disruption are consistent and potentially modifiable correlates of suicidal behavior across various diagnoses and age groups, supported primarily by longitudinal and prospective studies. Despite this, structured sleep assessment is seldom integrated into routine psychiatric care, predominantly due to cultural inertia and inadequate training. This perspective necessitates a shift: sleep assessment should be regarded alongside mood and cognition in every evaluation of suicide risk. Brief questionnaires and targeted interventions are readily accessible and feasible for implementation, thereby presenting concrete opportunities for prevention. By incorporating sleep evaluation into standard practice and future predictive models, psychiatry can advance toward more precise, actionable, and timely suicide prevention. To continue neglecting sleep is to overlook one of the most accessible and effective means of saving lives.