New $3.8M NIH grant funds research on 'mind after midnight' as a suicide risk factor
(From left) Sherap Sangpo, clinical research coordinator, and Michael Grandner, Sleep and Health Research Program director and associate professor of psychiatry, review settings for the Mind After Midnight research study. In the foreground is Denisse Armenta, program manager for the lab.
Kris Hanning/Office of Research and Partnerships
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Researchers with the Sleep and Health Research Program and the Center for Sleep, Circadian and Neuroscience Research in the University of Arizona College of Medicine – Tucson received a $3.8 million grant from the National Institute of Mental Health, a division of the National Institutes of Health, to examine how being awake in the middle of the night could impact a person's ability to make decisions.
The five-year study focuses on the "mind after midnight" hypothesis developed by U of A Department of Psychiatry researchers.
Michael Grandner
Kris Hanning/Office of Research and Partnerships
"The hypothesis is, if you are awake when your brain wants to be asleep, you are more likely to make impulsive and bad decisions," said lead investigator Michael Grandner, associate professor of psychiatry and associate director of the Center for Sleep, Circadian and Neuroscience Research. "We have consistently found – both through community and population epidemiological data – that suicides are three to four times more likely to occur between 2 a.m. and 4 a.m. than would be expected by chance. Knowing that people are not at their best in the middle of the night really isn't groundbreaking – but until now the neuroscience of exactly what is happening has been a mystery. Hopefully, this study can help us better understand what is going on and point the way towards reducing those risks."
The investigators will work with study participants at home and overnight in a sleep lab twice. In one of the lab visits, subjects will be kept awake until around 2 a.m. and then tested. For the other visit, they will be allowed to fall asleep, then awakened at 2 a.m. and tested.
The results will allow the researchers to evaluate how emotional processing, complex decision-making, and thoughts of hopelessness, disconnection, and stress may be experienced in the middle of the night. They will also examine how this relates to brainwave activity.
The "mind after midnight" hypothesis proposes that nocturnal wakefulness – an interruption in biological factors related to normal patterns of circadian rhythms, sleep and wakefulness – impairs the brain's complex decision-making functions and reduces rational thinking during a time when negative mood is at its peak, positive mood is at its lowest, people are often socially disconnected, and risk/reward processing is distorted.
"This is the first study of mood, neuropsychological function, and suicidality that probes both biological rhythmical and regulatory factors," said co-lead investigator Fabian-Xosé Fernandez, associate professor of psychology and neurology and faculty member of the Center for Sleep, Circadian & Neuroscience Research. "Through this research, we may uncover possible evidence-based treatments to reduce this modifiable suicide risk."
Grandner and Fernandez hope the research can eventually help reshape international suicide prevention strategies by targeting neurobiological mechanisms and tailoring treatments to reach individuals precisely at the time when they are struggling with overnight thoughts of self-harm.
"This is cutting-edge science that will generate new knowledge of the physiological mechanisms that drive elevated suicide risk at night," said Dr. Jordan F. Karp, professor and chair of the College of Medicine – Tucson's Department of Psychiatry. "This is important for advancing the fields of circadian science and suicide prevention."