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Suicide is an important public health concern with many factors contributing to increased risk. Sleep is one such factor that may elevate risk, yet this association is not well understood. By identifying the strongest sleep-related predictors of suicidal ideation (SI), providers may be able to better intervene and reduce risk of suicide. Methods Data were obtained from the clinical database at the National Intrepid Center of Excellence (NICoE). Patients were active duty service members, predominantly male, and with a mean age of 38. As part of standard care, patients receive a polysomnography sleep study and complete a battery of intake measures offering a comprehensive view of sleep. Individual symptoms were analyzed in an effort to understand the role of each sleep symptom within the context of the many other factors that may contribute to SI in service members. Results Of the many data points collected during polysomnography, only rapid eye movement (REM) sleep latency and minimum sleeping heart rate were related to SI. REM latency was associated with increased odds of SI, while minimum sleeping heart rate was related to decreased odds. Subjective reports of bad dreams, trauma-specific bad dreams, sleepiness, and sleep quality were related to increased odds of SI. Notably, subjective reports of sleep were associated with greater odds than objective measures. Traumatic nightmares had the greatest odds, with these patients being much more likely to have SI. Conclusion These results support the importance of considering sleep factors when evaluating SI in service members. Subjective sleep reports, specifically, appear to be particularly important, as they were associated with increased odds of SI. These findings focus on the role of individual sleep factors in increasing the odds of SI and suggest it is important to evaluate sleep in combination with comorbid conditions when conducting risk assessments. Support

1103 Understanding the Role of Sleep as a Risk Factor for Suicidal Ideation in Active Duty Service Members