Background: Schizophrenia (SZ) is one of the most prevalent psychological conditions, and a psychiatric history and mental health check diagnose it. There are no laboratory tests for schizophrenia. Signs and symptoms vary and involve alterations in emotion, perception, thinking, cognition, and behavior.

Objectives: This study aims to detect the prevalence of insomnia and the relation of insomnia to suicide for early recognition and reducing suicidal ideas in SZ cases that will be reflected for the benefit of the patient in a more structured and suitable management plan.

Subjects and methods: This cross-sectional study was performed at the Psychiatry Department, Faculty of Medicine, Zagazig University Hospitals. 210 cases were assessed according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) SZ's criteria. All cases conducted clinical and psychometric assessments including Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Positive and Negative Symptoms Scale (PANSS) measuring the severity of symptoms, Beck Scale for Suicidal Ideation (BSS), Calgary Depression Scale for Schizophrenics (CDSS), and Insomnia Severity Index (ISI).

Results: There was a significant association between depression and all of the sex, occupation, number of off-springs and coffee/tea drinks, off-spring, disease duration, hospitalization, insomnia severity, suicide, and suicide attempts (P<0.01). There was a statistically significant relation between suicidal ideation and all number of hospitalizations, positive, negative, general and total PANSS, insomnia severity, and depression (p<0.01).

Conclusion: These findings highlight the imperative of incorporating sleep-focused interventions into the comprehensive management of SZ to alleviate symptom burden and enhance overall well-being.