Leo Sher
Columbia University and New York State Psychiatric Institute, New York, New York, USA
Suicide in the Military. Hauppauge, New York: Nova Science Publishers, 2009, 210 pages.

Military service is frequently associated with reduced or disrupted sleep. Sleep abnormalities are common in individuals with suicidal behavior. Sleep studies have reported various polysomnographic abnormalities in suicidal persons. Considerable evidence supports a strong link between sleep disturbances and suicidality. Several years ago, a hypothesis on the significance of slow-wave activity and its homeostatic regulation has been proposed. It has been suggested that wakefulness is associated with synaptic potentiation in several cortical circuits; synaptic potentiation is tied to the homeostatic regulation of slow-wave activity; slow-wave activity is associated with synaptic downscaling; and active synaptic downscaling occurring during sleep is beneficial for cellular functions and is tied to overnight performance improvement. It is possible that disruption of synaptic homeostasis underlies sleep abnormalities leading or contributing to suicidal behavior. Further studies are needed to investigate possible mechanisms of sleep disturbances in suicidal behavior. The results of a recent study indicate the need for programs to help deployed military members get more and better sleep.