Issue Navigator

Volume 14 No. 09
Earn CME
Accepted Papers

Scientific Investigations

Total Sleep Time Interacts With Age to Predict Cognitive Performance Among Adults

Brian S. Mohlenhoff, MD1,2,3; Philip S. Insel, MS2,4,5; R. Scott Mackin, PhD1,2,5; Thomas C. Neylan, MD1,3; Derek Flenniken2,5; Rachel Nosheny, PhD2,5; Anne Richards, MD, MPH1,3; Paul Maruff, PhD6,7; Michael W. Weiner, MD1,2,3,4
1Department of Psychiatry, University of California, San Francisco, San Francisco, California; 2Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco, California; 3Mental Health Service, Department of Veterans Affairs Medical Center, San Francisco, California; 4Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California; 5San Francisco Veterans Affairs Medical Center, Veterans Health Research Institute (NCIRE), San Francisco, California; 6Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Australia; 7Cogstate, Ltd., Melbourne, Victoria, Australia

Study Objectives:

To investigate interactions between high and low amounts of sleep and other predictors of cognitive performance.


We used four cognitive tests to determine whether sleep time interacted with age, personal history of a memory problem, parental history of a memory problem, or personal concerns about memory and were associated with cognitive performance. Data were collected from an internet-based cohort study. We used an ordinary least squares regression with restricted cubic splines, controlling for demographic variables and comorbidities.


We found significant nonlinear interactions between (1) total sleep time and age and (2) total sleep time and personal history of a memory problem and cognitive performance. Short and long sleep durations and self-reported memory complaints were associated with poorer performance on a test of attention and this was true to a greater degree in younger and older adults. A repeat analysis excluding subjects reporting dementia was significant only for the test of attention.


These results extend existing data on sleep duration and cognition across the lifespan by combining in a single study the results from four specific cognitive tests, both younger and older adults, and four self-reported risk factors for cognitive impairment. Longitudinal studies with biomarkers should be undertaken to determine whether causal mechanisms, such as inflammation or amyloid buildup, account for these associations.


Mohlenhoff BS, Insel PS, Mackin RS, Neylan TC, Flenniken D, Nosheny R, Richards A, Maruff P, Weiner MW. Total sleep time interacts with age to predict cognitive performance among adults. J Clin Sleep Med. 2018;14(9):1587–1594.

Supplemental Material

Login to view supplemental material

Please login to continue reading the full article

Subscribers to JCSM get full access to current and past issues of the JCSM.

Login to JCSM

Not a subscriber?

Join the American Academy of Sleep Medicine and receive a subscription to JCSM with your membership

Subscribe to JCSM:  $75/volume year for individuals or $140/volume year for institutions to access all current articles and archives published in JCSM.

Download this article*:   $20 to access a PDF version of a specific article from the current issue of JCSM.

*Purchase of an electronic download of JCSM provides permission to access and print the issue/article for personal scholarly, research and educational use. Please note: access to the article is from the computer on which the article is purchased ONLY. Purchase of the article does not permit distribution, electronic or otherwise, of the article without the written permission of the AASM. Further, purchase does not permit the posting of article text on an online forum or website.