{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T07:01:11Z","timestamp":1790233271706,"version":"4.1.0"},"reference-count":66,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Cerebral small vessel disease (CSVD), a disorder that affects the cerebral microvasculature, is commonly associated with aging and may contribute to dementia and stroke. Increasing evidence suggests a link between CSVD and sleep disturbances, but the association remains poorly understood. This study, part of the population\u2010based Hamburg City Health Study, integrated portable sleep diagnostics (WatchPAT\u2010200) with brain imaging techniques sensitive to subtle microstructural (peak\u2010width of skeletonized mean diffusivity (PSMD)) and cortical alterations. Linear and logistic regression models were performed, accounting for demographic, sleep\u2010related covariates, and vascular risk factors, to elucidate the importance of sleep and the maintenance of cerebral vascular health in aging. In 154 participants (63.26\u2009\u00b1\u20098.19\u2009years, 41.56% women), sleep compositions characterised by a higher proportion of light sleep relative to deep sleep were associated with higher log\u2010transformed PSMD and lower cortical thickness. However, REM sleep relative to non\u2010REM sleep was not associated with log\u2010transformed PSMD or cortical thickness, and no associations were observed between sleep\u2010stage compositions and log\u2010transformed white matter hyperintensity (WMH) load or log\u2010transformed perivascular space (PVS) volume. Additionally, longer TST was associated with relevant sleep apnea. High\u2010resolution neuroimaging, combined with home sleep monitoring, suggests an association between sleep disturbances and greater CSVD\u2010related changes in aging. PSMD serves as a sensitive biomarker for early microstructural changes before visible damage occurs, thus supporting early detection to preserve cerebrovascular health. Given our cross\u2010sectional study design, the exact causality requires future longitudinal studies.<\/jats:p>","DOI":"10.1111\/jsr.70448","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T06:24:42Z","timestamp":1790231082000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Investigating the Link Between Objective Sleep Metrics and Cerebral Small Vessel Disease in a Population\u2010Based Cohort"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0242-8276","authenticated-orcid":false,"given":"Mareike","family":"Ludwig","sequence":"first","affiliation":[{"name":"Department of Neurology University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8996-978X","authenticated-orcid":false,"given":"Arne","family":"B\u00f6ttcher","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6426-7167","authenticated-orcid":false,"given":"Marvin","family":"Petersen","sequence":"additional","affiliation":[{"name":"Department of Neurology University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3774-6765","authenticated-orcid":false,"given":"Felix Leonard","family":"N\u00e4gele","sequence":"additional","affiliation":[{"name":"Department of Neurology University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4631-7519","authenticated-orcid":false,"given":"Maximilian","family":"Schell","sequence":"additional","affiliation":[{"name":"Department of Neurology University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6842-3259","authenticated-orcid":false,"given":"Jacob Friedrich","family":"Clausen","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4785-1449","authenticated-orcid":false,"given":"G\u00f6tz","family":"Thomalla","sequence":"additional","affiliation":[{"name":"Department of Neurology University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ines","family":"Sch\u00e4fer","sequence":"additional","affiliation":[{"name":"Epidemiological Study Center University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6609-1126","authenticated-orcid":false,"given":"Alena","family":"Haack","sequence":"additional","affiliation":[{"name":"Epidemiological Study Center University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3188-1026","authenticated-orcid":false,"given":"Christian","family":"Betz","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6400-5604","authenticated-orcid":false,"given":"Anna Sophie","family":"Hoffmann","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2434-1822","authenticated-orcid":false,"given":"Bastian","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Neurology University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.cobeha.2019.12.011","article-title":"Later\u2010Life Sleep, Cognition, and Neuroimaging Research: An Update for 2020","volume":"33","author":"Alfini A. 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