Evidence map›Paper›PMID 40719384›Full record

ArticleSleep2026

The association between sleep parameters, cognitive functioning, and markers of brain morphology: The Maastricht Study.

Tessa L van Baal, Sebastian Köhler, Annemarie Koster, Ree M Meertens, Hans Bosma, Miranda T Schram, Jacobus F A Jansen, Sami O Simons, Bastiaan E de Galan, Simone J P M Eussen and 2 more

Abstract read
In one paragraph

Article in Sleep, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. [Modifiable risk and protective factors for dementia: an overview of established and emerging evidence].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2026
    Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Tessa L van BaalMental Health and Neuroscience Research Institute (MHeNs), Maastricht University, Maastricht, The Netherlands.ORCID 0009-0005-9940-253X
Sebastian KöhlerMental Health and Neuroscience Research Institute (MHeNs), Maastricht University, Maastricht, The Netherlands.ORCID 0000-0002-2398-0609
Annemarie KosterCare and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.ORCID 0000-0003-1583-7391
Ree M MeertensCare and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.ORCID 0000-0001-8424-9142
Hans BosmaCare and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.ORCID 0000-0003-4333-4564
Miranda T SchramMental Health and Neuroscience Research Institute (MHeNs), Maastricht University, Maastricht, The Netherlands.ORCID 0000-0001-8113-7604
Jacobus F A JansenMental Health and Neuroscience Research Institute (MHeNs), Maastricht University, Maastricht, The Netherlands.ORCID 0000-0002-5271-8060
Sami O SimonsInstitute of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands.ORCID 0000-0002-4296-5076
Bastiaan E de GalanDepartment of Internal Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands.ORCID 0000-0002-1255-7741
Simone J P M EussenCare and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.ORCID 0000-0003-0559-6838
Niels JanssenMental Health and Neuroscience Research Institute (MHeNs), Maastricht University, Maastricht, The Netherlands.ORCID 0000-0003-2450-1558
Kay DeckersMental Health and Neuroscience Research Institute (MHeNs), Maastricht University, Maastricht, The Netherlands.ORCID 0000-0003-1339-2974

Funding

Dutch Ministry of Health, Welfare and Sport 1051003210005National Dementia Strategy 2021-2030The Netherlands Organization for Health Research and Development
6 · The paper itself

Abstract

STUDY

objectivesTo examine the association of objective and subjective sleep parameters with cognitive functioning and markers of brain morphology.

methodsThis cross-sectional study included 3360 participants (mean age: 59.5 ± 8.5 years; 51.1% female) from The Maastricht Study. Time in bed (TIB) and sleep breaks were objectively estimated using a thigh-worn accelerometer. Subjective sleep continuity was assessed via a single-item, and excessive daytime sleepiness was evaluated using the Epworth Sleepiness Scale. Cognitive testing was administered across three domains-memory, information processing speed, and executive functioning and attention. Markers of brain morphology (e.g. hippocampal volume, gray matter (GM) volume, and white matter volume) were assessed with 3 Tesla magnetic resonance imaging. Linear and logistic regression analyses modeled the associations.

resultsA longer TIB (h/night) was associated with worse executive functioning and attention (Blinear = -0.052, 95% CI = -0.084 to -0.019). Categorical analyses showed that a longer TIB (≥9 h/night) was associated with worse executive functioning and attention (B = -0.088, 95% CI = -0.166 to -0.010) compared to a mid-range TIB (≥7 to <9 h/night). A curvilinear association was found between TIB and lower GM volume (Bquadratic = -0.013, 95% CI = -0.025 to -0.001). Sleep breaks (≥2/night) were associated with worse overall cognition (B = -0.069, 95% CI = -0.124 to -0.013), information processing speed (B = -0.125, 95% CI = -0.212 to -0.039), and reduced GM volume (B = -0.068, 95% CI = -0.118 to -0.018). No significant associations were found for memory or other markers of brain morphology. Subjective sleep parameters showed no associations with cognitive functioning or markers of brain morphology.

conclusionsAdequate and uninterrupted TIB was associated with better cognitive functioning and brain morphology. Statement of Significance With the growing prevalence of dementia, the importance of reducing dementia risk is increasingly acknowledged. Sleep has been identified as a potential risk factor for cognitive decline and dementia, yet studies using objective measures of sleep remain limited. This study explores subjective and objective sleep parameters in relation to cognitive function and brain morphology in a large cohort. The findings show that a long time in bed (TIB) is negatively associated with executive functioning and attention, alongside a curvilinear relationship between TIB and gray matter volume. Additionally, sleep breaks (≥2/night) are linked to lower brain volume and poorer cognition. Future research should investigate longitudinal associations and other sleep aspects, including regularity and sleep disorders, to further our understanding and guide dementia prevention strategies.

Indexed as

BrainCognitionSleepAgedAttentionCross-Sectional StudiesExecutive FunctionFemaleGray MatterHumansMagnetic Resonance ImagingMaleMiddle AgedNeuropsychological Testsaccelerometrycognitive functiondementia risk reductionepidemiologyneuroimaging

Identifiers

PMID40719384
PMCPMC13016686

What Socratic holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.