Screening for suicide risk in adult sleep patients

Outpatient visits for sleep-related difficulties and the rate of suicide in the United States have both increased by more than 20% since 1999. Research suggests that anywhere from 75% to 91% of suicide decedents had contact with a physician within the year prior to fatally attempting suicide. Although the prevalence of such contacts among sleep clinicians is unknown, it is important to note that sleep disturbances in general are both a risk factor and potential warning sign for suicide. Screening for suicide risk among sleep patients is recommended, especially among those with a history of psychiatric and chronic medical conditions. Using evidence-based screening tools, such as the Columbia suicide severity rating scale, when screening patients for suicide risk is recommended despite the need for more research on the efficacy of suicide screening. For sleep clinic professionals who do not have the time to comprehensively assess and manage suicide risk, they are encouraged to implement suicide prevention policies within their departments and clinics and to follow the best available evidence to inform these policies. A protocol for screening for suicide risk in sleep clinics is outlined along with triage and documentation recommendations.