Suicidal IdeationMaMNCT07438912
Mind After Midnight
A study testing Sleep Pressure Manipulation in people with Suicidal Ideation and Circadian Rhythm Disorders, run by University of Arizona at 1 site in United States.
Trial 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… Read more about this study
- Who is it for?
- Ages 18 to 55 years
- Conditions the study is for
- Suicidal Ideation, Circadian Rhythm Disorders, Sleep Deprivation
- What is being tested?
- Sleep Pressure Manipulation
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 90 participants
- Where
- 1 siteUnited States
- Study dates
- 6 Mar 2026to 31 Aug 2029
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 55 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- 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
Who cannot join
- 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
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
United States1 site, 1 recruiting
- Recruiting
University of Arizona - Center for Sleep, Circadian, and Neuroscience Research
Tucson, Arizona, 85724
Kelsey McDermott, PhD, 520-626-0434 ext. 316486, kelseymcdermott@arizona.edu
About this study
Official title: The Mind After Midnight: Mechanistic Examination of Nocturnal Wakefulness as a Suicide Risk Factor
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.
Read the 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.
- Being tested
- Sleep Pressure Manipulation
- Keywords
- Nocturnal Wakefulness, Suicide Risk, Circadian Misalignment, Impulsivity, Mood Regulation, Biological Night, Sleep Pressure, Decision-Making
- Medical subject headings
- Suicidal Ideation, Chronobiology Disorders, Sleep Deprivation, Sleep Wake Disorders, Impulsive Behavior
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Sleep Pressure ManipulationBehavioural
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.
| Study group | Role | What they receive |
|---|---|---|
| High Sleep Pressure Condition | Experimental | 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. Receives: Behavioral: Sleep Pressure Manipulation |
| Low Sleep Pressure Condition | Experimental | 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. Receives: Behavioral: Sleep Pressure Manipulation |
What is being measured
The primary outcome is the main question the study is designed to answer.
Feelings of Hopelessness
Total score on the BECK Hopelessness scale (BHS)
Measured: Visit 1(day 2, night 2), Visit 2 (day 2, night 2)
Impaired Executive Function
BART total score
Measured: Visit 1(day 2, night 2), Visit 2 (day 2, night 2)
Negative Mood
PANAS negative affect score
Measured: Visit 1(day 2, night 2), Visit 2 (day 2, night 2)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Feb 2026
- Study start6 Mar 2026
- Primary completion28 Feb 2029 (estimated)
- Study completion31 Aug 2029 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Suicidal IdeationStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Basic science
- Allocation
- Randomised
- Intervention model
- Crossover
- 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.
- Masking
- None (open label)
- Enrolment
- 90 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of Arizona
- Sponsor type
- University, hospital or other
- Collaborators
- National Institute of Mental Health (NIMH)
- Responsible party
- Principal investigator, MICHAEL A GRANDNER, University of Arizona
- Investigators
- Michael A Grandner, PhD, Principal investigator, University of Arizona
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07438912
- Sponsor's protocol ID
- R01MH135978
- Acronym
- MaM
- Status last verified
- Sep 2026
- First submitted
- 11 Feb 2026
- Last updated
- 1 Oct 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 1 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Mind After Midnight: Mechanistic Examination of Nocturnal Wakefulness as a Suicide Risk Factor
- ClinicalTrials.gov ID
- NCT07438912
- Acronym / sponsor ID
- MaM / R01MH135978
- Keywords
- Nocturnal Wakefulness, Suicide Risk, Circadian Misalignment, Impulsivity, Mood Regulation, Biological Night, Sleep Pressure, Decision-Making
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 90 participants (estimated)
- Lead sponsor
- University of ArizonaUniversity, hospital or other
- Collaborators
- National Institute of Mental Health (NIMH)
- Study start
- 6 Mar 2026 (actual)
- Primary completion
- 28 Feb 2029 (estimated)
- Study completion
- 31 Aug 2029 (estimated)
- First posted
- 27 Feb 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
Study design
- Primary purpose
- Basic science
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- None (open label)
- Number of arms
- 2
- 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.
| Arm | Type | Receives |
|---|---|---|
| High Sleep Pressure Condition | Experimental | Behavioral: Sleep Pressure ManipulationParticipants 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. |
| Low Sleep Pressure Condition | Experimental | Behavioral: Sleep Pressure ManipulationParticipants 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. |
Who may qualify
- Ages
- 18 to 55 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (5 listed)
- 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
Key exclusion criteria (8 listed)
- 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
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Sleep Pressure ManipulationParticipants 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. | Behavioural | High Sleep Pressure Condition, Low Sleep Pressure Condition |
Primary outcome
Feelings of Hopelessness
Time frame: Visit 1(day 2, night 2), Visit 2 (day 2, night 2)
Total score on the BECK Hopelessness scale (BHS)
Impaired Executive Function
Time frame: Visit 1(day 2, night 2), Visit 2 (day 2, night 2)
BART total score
Negative Mood
Time frame: Visit 1(day 2, night 2), Visit 2 (day 2, night 2)
PANAS negative affect score
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 1 Oct 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Michael A Grandner, PhD principal investigator
University of Arizona
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Sleep Pressure Manipulation in people with Suicidal Ideation and Circadian Rhythm Disorders, run by University of Arizona at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 1 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Denisse Armenta (5206261737, armentamd@arizona.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Feelings of Hopelessness (time frame: Visit 1(day 2, night 2), Visit 2 (day 2, night 2)). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Oct 2026.