Using Alcohol and Sleep Sensors to Understand Blackout Risk in Young Adults' Natural Settings (The Lights Out Study): Protocol for an Intensive Longitudinal Pilot Study.
Richards V, Braun A, et al. • JMIR research protocols • 2026
This paper describes a protocol for a 14-day intensive longitudinal pilot study using wearable alcohol and sleep sensors combined with ecological momentary assessment to examine how other substance use and sleep behaviors are associated with alcohol-induced blackout risk in young adults.
Key Findings
Background
Alcohol-induced blackouts (AIBs) are described as common and recurrent among young adults who drink and are strongly associated with excess alcohol-related harms.
AIBs are characterized as 'a serious consequence of alcohol use'
The paper identifies AIBs as 'common and recurrent among young adults who drink'
Risk factors include dynamics of alcohol use (quantity, speed, duration), alcohol-related behaviors (e.g., playing drinking games, not using protective behavioral strategies), and factors related to subjective experience of intoxication (e.g., expectancies, motivations)
Background
The study identifies two modifiable behaviors — other substance use and sleep — as potentially associated with AIB risk due to their known impacts on alcohol consumption and subjective intoxication.
Both behaviors 'have been shown to impact both alcohol consumption and subjective experiences of intoxication'
These behaviors are described as 'modifiable,' suggesting potential intervention targets
The study's focus on these two behaviors is framed as filling a gap in understanding AIB risk
Methods
The study will recruit approximately 50 participants who report recent heavy episodic drinking and AIBs.
Eligibility criteria require participants to be young adults who report 'recent heavy episodic drinking and AIBs'
Recruitment involves an online screening assessment followed by an in-person baseline visit for eligible individuals
The sample size of approximately 50 is described as a pilot study
Methods
The study protocol involves a 14-day intensive data collection period using twice-daily scheduled mobile surveys, participant-initiated drinking surveys with hourly follow-ups, and continuous wearable sensor data.
Two wearable sensors are used: a wrist-worn alcohol sensor (BACtrack Skyn) and a sleep or activity ring sensor (Oura ring)
Participants complete 'twice daily scheduled mobile surveys and participant-initiated drinking surveys with hourly follow-ups'
Both sensors are worn 'continuously during this 14-day period'
The approach integrates ecological momentary assessments (EMA) with objective sensor data
Methods
The study design includes an in-person baseline visit, a 14-day intensive data collection period, and an in-person return visit for sensor return and follow-up survey completion.
At the baseline visit, participants 'complete a baseline assessment, be fitted with a wrist-worn alcohol sensor (BACtrack Skyn) and a sleep or activity ring sensor (Oura ring), and receive training on the study protocol'
After the 14-day period, participants complete 'an in-person return visit to return their sensors, complete a follow-up survey, and receive compensation'
Data analyses will include 'multi-level structural equation models'
Methods
The study was funded in July 2025 with data collection projected to span January 2026 through June 2026.
This is a pilot study designed to 'enhance preliminary data on the feasibility and acceptability of these methods'
The study is intended to provide 'opportunities for conducting future research on a larger scale'
The findings are also anticipated to support 'potential applications in future digital interventions'
Conclusions
The integration of ecological momentary assessment with alcohol and sleep sensors is identified as supporting potential applications in future digital interventions targeting AIB risk.
The study explicitly notes that 'the integration of ecological momentary assessments with 2 sensors to capture alcohol use and sleep also supports potential applications in future digital interventions'
The pilot is framed as building a foundation for larger-scale research
Feasibility and acceptability of the combined sensor-EMA methodology are stated outcomes of interest
What This Means
This research describes the design of a study called the 'Lights Out Study,' which aims to better understand why some young adults experience alcohol-induced blackouts (AIBs) — episodes where a person drinks so much that they cannot later remember what happened. The study focuses on two behaviors that researchers believe might increase blackout risk but that can potentially be changed: how much and what other substances a person uses alongside alcohol, and how well they sleep. To study this, approximately 50 young adults who regularly drink heavily and have experienced blackouts will wear two devices — a wristband that detects blood alcohol levels through the skin and a ring that tracks sleep — for 14 days straight, while also answering surveys on their phones multiple times a day about their drinking and experiences.
This research suggests that combining wearable sensor technology with frequent smartphone surveys (a method called ecological momentary assessment) can capture real-world drinking behavior more accurately than asking people to recall their habits in a clinic setting. By collecting data on alcohol levels, sleep patterns, and drinking behaviors simultaneously as they happen in everyday life, the researchers hope to identify specific combinations of factors — such as poor sleep before a night of drinking, or mixing alcohol with other substances — that meaningfully raise the risk of blacking out. The study is specifically designed as a pilot, meaning it is also testing whether these methods are practical and acceptable to participants before being used in a larger study.
This research matters because AIBs are associated with serious harms including accidents, sexual assault, and risky decision-making, and they are common among young adults. Understanding which modifiable behaviors increase blackout risk could eventually inform the design of digital tools or apps that warn individuals when their risk is elevated and suggest behavior changes in the moment. The study's timeline places data collection in the first half of 2026, with the goal of building toward larger-scale research and real-world interventions.
Richards V, Braun A, Sladek M, Zhao J, Leffingwell T, Newell Chesebro S, et al.. (2026). Using Alcohol and Sleep Sensors to Understand Blackout Risk in Young Adults' Natural Settings (The Lights Out Study): Protocol for an Intensive Longitudinal Pilot Study.. JMIR research protocols. https://doi.org/10.2196/83980