BACKGROUND: Prior studies on the association between sleep disturbances and 
suicidal behavior did not explore whether or not short sleep is a marker of 
suicide intent, lethality or risk.
DESIGN: Cross-sectional.
PARTICIPANTS: Suicide attempters (SAs) (n=434). Controls included 83 psychiatric 
inpatients who have never been SAs, and 509 healthy controls.
MEASUREMENTS: Short sleep was defined by self-assessment as ≤ 5 h per day. The 
MINI and the DSM-IV version of the International Personality Disorder 
Examination Screening Questionnaire were used to diagnose Axis I and Axis II 
diagnoses, respectively. Suicide intent and lethality were evaluated through the 
Beck's Suicidal Intent Scale (SIS) and the Risk-Rescue Rating Scale (RRRS), 
respectively. Beck's Medical Lethality Scale (BMLS) was administered to assess 
the degree of medical injury, and the SAD PERSONS mnemonic scale was used to 
evaluate suicide risk.
STATISTICAL ANALYSES: Chi-square tests and logistic regression analyses explored 
frequencies of short sleep in 3 samples. Chi-square tests explored whether or 
not suicide intent, lethality and risk were greater in SAs with short-sleep 
versus those without short-sleep.
RESULTS: Short sleep was more prevalent in SAs than in psychiatric controls only 
in males. In female SAs, short sleep was significantly associated with several 
SIS items and high scores in the SAD PERSONS.
LIMITATIONS: Sleep duration was assessed only by self-report.
CONCLUSIONS: The association between short sleep and suicidal behavior may be 
partly explained by confounders. Short sleep may be a marker of severity of 
suicidal behavior among female SAs.