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Introduction Suicide is the second-leading cause of death for young adults and insomnia increases suicide risk. However, the data on disrupted sleep and suicidal ideation in college students is mixed, including whether disrupted sleep fits into the framework of the Interpersonal Theory of Suicide. Therefore, the present study explored how four different sleep variables influenced recent suicidal ideation in a collegiate sample. Methods Data from N=506 respondents were collected as part of the Assessing Nocturnal Sleep/Wake Effects on Risk of Suicide (ANSWERS) Survey in college students. The primary outcome, active suicidal ideation in the last 3 months, was assessed using several self-report questions derived from the Columbia Suicide Severity Rating Scale. The predictors were weekday short sleep (≤6h; assessed by retrospective sleep diary), Insomnia Severity Index (ISI) score, Brief Inventory of Sleep Control (BRISC) score, and Disturbing Dreams and Nightmares Severity Index (DDNSI) score. Binomial logistic regression models estimated the associations between suicidal ideation and sleep variables in models that were unadjusted, adjusted for age, sex, race, and ethnicity, and additionally adjusted for thwarted belongingness or perceived burdensomeness (constructs from the Interpersonal Theory of Suicide). Results A total of N=121 (23.9%) respondents endorsed suicidal ideation in the last 3 months. Individuals with suicidal ideation were in poorer health (p&amp;lt;0.001) and had more severe depression (p&amp;lt;0.001) and anxiety (p&amp;lt;0.001). In unadjusted models, individuals were more likely to report suicidal ideation if they had short sleep (OR 1.93 [1.23–3.05]), ISI scores of 8 or more (OR 3.01 [1.94–4.74]), and DDNSI scores of 10 or more (OR 2.66 [1.69–4.19]). Higher BRISC scores were associated with lower odds of suicidal ideation (OR 0.53 [0.41–0.68]). Adjusting for age, sex, race, ethnicity, thwarted belongingness, and perceived burdensomeness attenuated but did not eliminate any of these relationships. Conclusion Insomnia, short sleep, nightmares, and less perceived sleep control were all associated with recent suicidal ideation in college students. Moreover, these findings were generally independent of the Interpersonal Theory of Suicide. Further research is needed to understand how sleep affects suicide risk in this population, and whether sleep interventions can reduce this risk. Support (if any):

775 The Relationship Between Sleep and Suicidal Ideation in College Students