NCT07438912

Mind After Midnight

The Mind After Midnight: Mechanistic Examination of Nocturnal Wakefulness as a Suicide Risk Factor

• Status: Recruiting
• Phase: N/A
• Study type: Interventional
• Enrollment: 90 (estimated)
• Sponsor: University of Arizona · Academic / Other
• Sex: All
• Age: 18 Years – 55 Years
• Healthy volunteers: Not accepted

Summary

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.

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.

Conditions

• Suicidal Ideation
• Circadian Rhythm Disorders
• Sleep Deprivation
• Sleep Wake Disorders

Interventions

Type	Name	Description
BEHAVIORAL	Sleep Pressure Manipulation	Participants undergo an experimental manipulation of homeostatic sleep pressure involving controlled wakefulness or scheduled awakening during the biological night. Mood, suicidal ideation, impulsivity, and decision-making are assessed during overnight laboratory sessions.

Timeline

• Start date: 2026-03-01
• Primary completion: 2029-02-28
• Completion: 2029-08-31
• First posted: 2026-02-27
• Last updated: 2026-02-27

Locations

1 site across 1 country: United States