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Being awake at night significantly increases suicide risk. This study found suicide rates are 3.6 times higher during nighttime hours compared to what would be expected by chance.

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Area of Science:

  • Public Health
  • Sleep Medicine
  • Criminology

Background:

  • Suicide is a major public health concern in the US.
  • Insomnia and nightmares are known risk factors for suicidal ideation and behavior.
  • The specific risk associated with being awake during nighttime hours remains under-investigated.

Purpose of the Study:

  • To evaluate the hourly frequency of completed suicides.
  • To determine if nighttime wakefulness poses a unique suicide risk.
  • To identify modifiable risk factors for suicide prevention.

Main Methods:

  • Archival analysis of completed suicide data (2003-2010) from the National Violent Death Reporting System.
  • Analysis of hourly population wakefulness data from the American Time Use Survey.
  • Statistical comparison of observed suicide incident rates against expected rates based on wakefulness.

Main Results:

  • The mean suicide incident rate between 00:00-05:59 was 10.3%, significantly higher than the 2.2% rate from 06:00-23:59.
  • The highest incident rate occurred between 02:00-02:59 (16.3%).
  • Overall nighttime suicide frequency was 3.6 times higher than expected by chance (P < .001).

Conclusions:

  • Wakefulness during nighttime hours is associated with a substantially elevated risk for suicide.
  • Sleep disturbances and disruptions in circadian rhythms may potentiate suicide risk.
  • Targeting nighttime awakeness could be a novel strategy in suicide prevention efforts.