# Nocturnal wakefulness, cognitive control, and suicidal urges: A prospective evaluation of variance during residential treatment

> **NIH NIH R21** · UNIVERSITY OF PENNSYLVANIA · 2021 · $202,761

## Abstract

Project Summary/Abstract
 Alterations in nocturnal wakefulness and cognitive control are both associated with suicidal thoughts and
 behaviors in cross-sectional research, but given the methodological limitations of this work, the role that these
alterations play in proximal suicide risk remains unclear. We propose to intensively assess veterans with
 insomnia and suicidal ideation recruited from a posttraumatic stress disorder (PTSD) residential unit to explore
 the associations among nocturnal wakefulness, cognitive control, and suicide risk. We also anticipate that the
associations observed between nocturnal wakefulness, cognitive control, and suicidal ideation will not be
 exclusive to PTSD, but that PTSD serves as an ideal population in which to test these associations given the
 importance of disturbances in nocturnal wakefulness, cognitive control, and suicidal ideation among patients with
 the disorder. The aims are:
 Aim 1: To evaluate associations between nocturnal wakefulness and suicide ideation prospectively, in
 veterans with PTSD. Hypothesis 1: Longer duration of nocturnal wakefulness, as indexed by minutes awake
 from 11 PM – 7 AM based on movement on the mattress sensor strip, will be associated with higher next-day
 suicidal ideation, above and beyond the influence of PTSD and depression severity, baseline sleep disorder
 symptoms, and demographic variables (e.g., age, gender, race/ethnicity).
 Aim 2: To evaluate associations between cognitive control and suicidal ideation prospectively, in veterans with
PTSD. Hypothesis 2: Reduced cognitive control (daily cognitive task performance, completed in the morning hours
and when awake at night) will be associated with higher subsequent suicidal ideation, above and beyond the
influence of PTSD and depression severity, baseline cognitive control performance, and demographic variables.
 Aim 3: To evaluate evidence for cognitive control as a mediator of the association between nocturnal
wakefulness and suicidal ideation prospectively, in veterans with PTSD. Hypothesis 3: The association between
nocturnal wakefulness and suicidal ideation will be partially mediated by reduced cognitive control performance.
 This R21 will support a subsequent R01 project to test an algorithm for the classification of suicidal ideation
 and behavior based on alterations in nocturnal wakefulness and cognitive control, utilizing methods from this
 proposal as well as additional levels of analysis (e.g., neural activation). We plan for the results of the proposed
 project to inform a new line of applied research that will directly utilize our results to develop new ecological
 momentary intervention strategies aimed at mitigating proximal suicide risk.

## Key facts

- **NIH application ID:** 10128689
- **Project number:** 1R21MH123888-01A1
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Keith Eric Bredemeier
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $202,761
- **Award type:** 1
- **Project period:** 2020-12-01 → 2022-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10128689

## Citation

> US National Institutes of Health, RePORTER application 10128689, Nocturnal wakefulness, cognitive control, and suicidal urges: A prospective evaluation of variance during residential treatment (1R21MH123888-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10128689. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*