HealthcareNursingPatient Safety

It’s Time to Make Sleep a Vital Sign: Continuing Clinical Excellence through Evidence-based Practice

Dr. Ian J. Lynch

Unified Nursing Research, Midwifery & Women’s Health Journal
Author: Dr. Ian J. Lynch
Affiliation: Tripler Army Medical Center
Category: Abstract

Unified Citation Journals, 3(1) 1-2;
ISSN 2754-0944

Keywords: Sleep, Health Conditions, Psychiatric Diagnoses, Suicidality

Sleep is a ubiquitous human behavior required for all aspects of health, and consequences of insufficient
sleep profoundly impact all facets therein. Numerous studies demonstrate the unequivocal relationship between sleep impairments and many medical, and psychiatric conditions. Insufficient sleep is often overlooked or seen as inconsequential by patients providers because sleep has been traditionally viewed
as a passive activity (Malhotra, R. K., & Desai, A. K.2010). Notwithstanding, sleep disruption is a directly measurable variable amenable to brief interventions The following cross-disciplinary evidence review attempts to address the gap between research and practice by adding sleep as a ‘vital sign’
in comprehensive clinical assessments.

When considering physical health, insufficient sleep predicts poor outcomes including: common cold susceptibility [1] increased hypertension, and insulin resistance[2]; increased risk of obesity, cardiovascular complications, premature death and all-cause mortality[3]. Impaired sleep is also associated with the development and maintenance of anxiety, depressive, panic, and posttraumatic stress disorders[4]. Of specific importance, insufficient sleep is directly linked suicidal thinking and behavior over above other common factors including depression, anxiety, relationship distress, and substance use. A recent meta analysis found the strongest predictor of suicide death was insomnia (OR 2.10).[5] Sleep is inextricably linked to physical, cognitive, and mental functioning, and sleep impairments predict cascading health consequences. Emphasizing sleep in clinical practice will allow healthcare providers to address a modifiable risk factor across the spectrum of health, including suicidal thoughts and behaviors.


Dr. Ian Lynch is the Director of the Behavioral Health Intensive Outpatient Program at Tripler Army Medical Center in Honolulu, HI. His experiences span clinical, academic, and research domains—all combined with over 24 years of tenure of military service. Dr. Lynch received his Psy.D. from Spalding University in 2014. His clinical interests include the assessment and treatment complex psychopathology including suicidality within military personnel & settings. He has delivered over 20 presentations including several at national and
international academic conference forums on topics including sleep and health; insomnia & suicide within military & veteran populations

[1] Drake, C. L., Roehrs, T. A., Royer, H., Koshorek, G., Turner, R. B., & Roth, T., 2000);
[2] (Gangwisch, J. E., 2014); Chattu, V. K., Chattu, S. K., Burman, D., Spence, D. W.; Pandi-Perumal, S. R. 2019);
[3] Chattu VK, Manzar MD, Kumary S, Burman D, Spence DW, PandiPerumal SR. The Global Problem of Insufficient Sleep and Its Serious Public Health Implications. Healthcare (Basel). 2018 Dec 20;7(1):1;
[4] Krystal AD. Psychiatric disorders and sleep. Neurol Clin. 2012 Nov;30 (4):1389-413; [4] Harris LM, Huang X, Linthicum KP, Bryen CP, Ribeiro JD. Sci Rep. 2020 Aug 17;10(1):13888).

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