Evidence map›Paper›PMID 41834038›Full record

ArticleBMC medicine2026

The Young Adult Sleep model: an evolving causal loop diagram of mental health dynamics.

Jeroen F Uleman, Rushd F M Al-Shama, Adrian G Zucco, Jette Echterhoff, Maartje Luijten, Maaike Verhagen, Jana Vyrastekova, Jorien L Treur, Robyn E Wootton, Sicelo Jones and 6 more

Abstract read
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In one paragraph

Article in BMC medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Review
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

16 authors.

Jeroen F UlemanCopenhagen Health Complexity Center, Department of Public Health, University of Copenhagen, Copenhagen, Denmark. jeroen.uleman@sund.ku.dk.
Rushd F M Al-ShamaDepartment of Clinical and Experimental Cardiology and Cardiothoracic Surgery, Heart Center, Amsterdam , UMC Location University of Amsterdam, Amsterdam, The Netherlands.
Adrian G ZuccoCopenhagen Health Complexity Center, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Jette EchterhoffCopenhagen Health Complexity Center, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Maartje LuijtenBehavioural Science Institute, Faculty of Social Sciences, Radboud University, Nijmegen, The Netherlands.
Maaike VerhagenBehavioural Science Institute, Faculty of Social Sciences, Radboud University, Nijmegen, The Netherlands.
Jana VyrastekovaInstitute for Management Research, Radboud University, Nijmegen, The Netherlands.
Jorien L TreurDepartment of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.
Robyn E WoottonSchool of Psychological Science, University of Bristol, Bristol, UK.
Sicelo JonesDonders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
Martin DreslerDonders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
Henning J DrewsDepartment of Public Health, University of Copenhagen, Copenhagen, Denmark.
Christine EgebjergDepartment of Neuroscience, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Birgitte R KornumDepartment of Neuroscience, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Karien StronksDepartment of Public and Occupational Health, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Naja Hulvej RodCopenhagen Health Complexity Center, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

Funding

European Research Council 101076686European Research Council 101124807Lundbeck Foundation R344-2020-749Lundbeck Foundation R396-2022-352Nederlandse Organisatie voor Wetenschappelijk Onderzoek 016.Vidi.185.142South-Eastern Norway Regional Health Authority 2020024TrygFonden 157232ZonMw 04520232320007
6 · The paper itself

Abstract

backgroundThis study introduces the Young Adult Sleep model, a comprehensive causal loop diagram (CLD) developed to explore the dynamic feedback mechanisms underlying sleep problems and affective depressive symptoms in young adults-an urgent public health challenge.

methodsThe CLDs was developed through five asynchronous questionnaire-based assignments completed by a panel of 14 domain experts, two existing CLDs, and targeted reviews of the scientific literature. Natural language processing was used to curate the system variables from questionnaire data.

resultsThe CLD integrates extensively interconnected variables across biological, psychological, behavioral, and social domains. It comprises 29 variables and 175 causal connections, forming numerous reinforcing feedback loops that can drive "vicious" cycles, such as the interplay of sleep disturbances and affective depressive symptoms with addictive behaviors like smoking. The experts also identified balancing loops that may counteract these self-reinforcing dynamics. Many loops span multiple domains, underscoring the importance of multidomain interventions and of interdisciplinary research that synthesizes evidence across scientific fields.

conclusionsThe Young Adult Sleep model is an evolving CLD framework that is intended to be further refined as new evidence becomes available. It supports iterative theory development and hypothesis generation, and serves as a foundation for future computational modeling to simulate intervention strategies to address this complex public health problem.

Indexed as

DepressionMental HealthSleepSleep Wake DisordersHumansSurveys and QuestionnairesYoung AdultCausal loop diagramComplexDepressive symptomsEpidemiologyFeedback loopMental healthNatural language processingSleepSystemYoung Adult

Identifiers

PMID41834038
PMCPMC12990402

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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 OpenQuestion graph.