Mind After Midnight
Purpose
This study examines whether wakefulness during the biological night (2:00-4:00 AM) is associated with increased negative mood, impaired decision-making, and suicidal thoughts. Adults with a history of suicidal ideation in the past six months will complete laboratory and home-based assessments under varying levels of sleep pressure. Participants will be evaluated during late-night wakefulness and under conditions of both higher and lower sleep pressure. The goal of the study is to better understand the biological and behavioral mechanisms that may contribute to elevated suicide risk during nocturnal wakefulness.
Conditions
- Suicidal Ideation
- Circadian Rhythm Disorders
- Sleep Deprivation
- Sleep Wake Disorders
Eligibility
- Eligible Ages
- Between 18 Years and 55 Years
- Eligible Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- Age 18-55 years - History of suicidal ideation within the past 6 months - Habitual bedtime between 9:00 PM and 1:00 AM - Habitual wake time between 6:00 AM and 9:00 AM - Ability to provide informed consent
Exclusion Criteria
- Current suicidal intent requiring immediate clinical intervention - Diagnosis of a primary sleep disorder (e.g., untreated obstructive sleep apnea, narcolepsy) - Bipolar disorder or psychotic disorder - Substance use disorder within the past 3 months - Use of medications that significantly affect sleep or circadian rhythms - Night shift work or transmeridian travel within the past month - Medical or neurological condition that would interfere with participation - Pregnancy
Study Design
- Phase
- N/A
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Crossover Assignment
- Intervention Model Description
- Participants will complete laboratory assessments under two experimental sleep pressure conditions in a within-subject crossover design. In one condition, participants will remain awake until 2:00 AM (high sleep pressure). In the other condition, participants will sleep and be awakened at 2:00 AM (low sleep pressure). Mood, suicidal ideation, and decision-making will be assessed during the biological night under both conditions.
- Primary Purpose
- Basic Science
- Masking
- None (Open Label)
- Masking Description
- This study is open-label. Participants and study personnel are aware of the assigned sleep pressure condition (high sleep pressure or low sleep pressure), as the experimental manipulation involves remaining awake or being awakened during the biological night.
Arm Groups
| Arm | Description | Assigned Intervention |
|---|---|---|
|
Experimental High Sleep Pressure Condition |
Participants will remain awake until 2:00 AM to induce high homeostatic sleep pressure. During the biological night (2:00-4:00 AM), participants will complete assessments of mood, suicidal ideation, impulsivity, and decision-making under conditions of sustained wakefulness. |
|
|
Experimental Low Sleep Pressure Condition |
Participants will be allowed to sleep and will be awakened at 2:00 AM to induce lower homeostatic sleep pressure. During the biological night (2:00-4:00 AM), participants will complete assessments of mood, suicidal ideation, impulsivity, and decision-making following sleep and acute awakening. |
|
Recruiting Locations
Tucson, Arizona 85724
More Details
- Status
- Recruiting
- Sponsor
- University of Arizona
Detailed Description
Suicide risk is elevated during the biological night, particularly between 2:00 and 4:00 AM. Observational and epidemiologic data suggest that nocturnal wakefulness is associated with increased negative affect, impaired decision-making, and greater suicidal ideation. The "Mind After Midnight" hypothesis proposes that wakefulness during the biological night exposes individuals to a combination of circadian vulnerability and homeostatic sleep pressure that contributes to emotional and cognitive dysregulation. This study will recruit approximately 90 adults with a history of suicidal ideation in the past six months. Participants will complete both home-based and laboratory-based procedures. Laboratory assessments will evaluate mood, hopelessness, suicidal ideation, impulsivity, and decision-making at different times of day, including 2:00-4:00 AM. To examine the role of homeostatic sleep pressure, participants will complete late-night assessments under two conditions: (1) high sleep pressure (remaining awake until 2:00 AM) and (2) low sleep pressure (sleeping and being awakened at 2:00 AM). Circadian factors will be assessed using behavioral measures and physiologic markers, including melatonin. The goal of the study is to experimentally test whether nocturnal wakefulness contributes to suicide-associated cognitive and affective processes and to identify underlying chronobiological mechanisms.