Aspects of sleep may be recorded in moderately suicidal persons using fully remote, zero-burden methods, with observed associations highlighting potential relevance to suicide surveillance and prevention.
High-risk Veterans went to bed significantly earlier than low-risk participants.
Total minutes-in-bed and out-of-bed times were negatively correlated with measures of suicidal ideation and cognition within the high-risk group.
Earlier in-bed times were modestly predictive of increased suicidal symptoms in high-risk Veterans even after accounting for self-reported depression.
High-risk and low-risk Veterans differed significantly on measures of depression and suicidality at baseline.
A fully remote, zero-burden mattress actigraphy system successfully recorded in-home sleep data from Veterans at high and low risk for suicide.
This research suggests that it is feasible to continuously monitor sleep patterns of military Veterans who are at high risk for suicide using a simple, low-cost device placed under their mattress at home. After an initial phone call to help with setup, participants did not need to do anything else — the device automatically sent sleep data to a secure cloud server every night. This approach allowed researchers to collect weeks of real-world sleep data without placing any ongoing burden on participants who may already be struggling. The study found that Veterans at high risk for suicide went to bed about an hour earlier than those at lower risk, and that certain sleep patterns — specifically spending more time in bed and getting out of bed later — were associated with lower levels of suicidal thoughts and related thinking. Importantly, going to bed earlier from week to week was linked to increases in suicidal symptoms, and this relationship remained even after accounting for depression levels, suggesting sleep timing may carry independent warning-sign value. This research suggests that passively collected, objective sleep data gathered entirely at home could eventually be used as part of a system for monitoring suicide risk over time, particularly in Veterans with PTSD. Because the method requires no ongoing effort from participants, it may be especially practical for use in populations where engagement with traditional clinical monitoring is difficult. The findings are preliminary and based on a relatively small sample, but they point toward the potential value of sleep monitoring as a tool for suicide surveillance and prevention.
Woodward S, Ong L, Villasenor D, Arsenault N, Pigeon W, Khan C, et al.. (2026). Remote zero-burden sleep monitoring in veterans with PTSD and suicidal ideation: A longitudinal investigation of risk.. Journal of affective disorders. https://doi.org/10.1016/j.jad.2026.121184