Review 1 Mention
Sleep disorders and the risk of cognitive decline or dementia: an updated systematic review and meta-analysis of longitudinal studies
Jinhuan Zhang2025
Juan OuXiaoting Lu
Average · 50th percentile
17 citations · Experimental and Cognitive Psychology
Open Access

TLDR

People who have trouble sleeping are more likely to have problems with memory and thinking as they get older. Taking care of sleep problems early could help protect the brain.

Summary

1 Study Aim

The main goal of this paper is to update and clarify the link between different types of sleep disorders (such as insomnia, sleep apnea, restless legs, and poor sleep quality) and the risk of developing cognitive decline or dementia over time. The authors aim to determine which specific sleep problems are most strongly connected to later memory and thinking issues, using the latest available research. Not getting enough good sleep may raise the risk of memory and thinking problems later in life.

2 Study Design

The authors conducted a systematic review and meta-analysis, which means they searched for and combined results from many previous studies. They included 76 high-quality cohort studies that followed adults over time to see if those with sleep disorders developed cognitive decline or dementia. The studies covered eight types of sleep problems and used both self-reported and objective measures. The researchers used statistical methods to pool risk estimates, check for bias, and explore differences between studies. The researchers combined results from many long-term studies to see if sleep problems lead to memory loss or dementia.

3 Findings

The research demonstrates that several sleep disorders—including insomnia (trouble falling or staying asleep), sleep-related breathing disorders (like sleep apnea), excessive daytime sleepiness (feeling very tired during the day), sleep-related movement disorders (such as restless legs syndrome), poor sleep quality, and both short and long sleep duration—are linked to a higher risk of cognitive decline and dementia. The strongest links were found for restless legs syndrome and excessive daytime sleepiness, especially with vascular dementia. Both sleeping less than 7 hours and more than 8 hours per night increased risk. The authors argue that managing sleep problems is a key way to help prevent memory and thinking problems. They recommend regular screening and early treatment of sleep disorders in adults to lower the risk of dementia. Taking care of sleep problems could help prevent memory and thinking issues as people age.

Abstract

BACKGROUND: The evidence on the relationship between sleep disorders and the risk of cognitive decline or dementia remains inconsistent. OBJECTIVES: This systematic review and meta-analysis aimed to provide updated evidence on the association between sleep disturbances and cognitive decline. METHODS: PubMed, EMBASE, and Web of Science were systematically searched from their respective inceptions to 18 February 2025. Cohort studies investigating longitudinal associations between sleep disorders and cognitive decline or dementia were included. Pooled relative risks (RRs) with 95% confidence intervals were calculated. Sensitivity analyses were conducted to evaluate the robustness of the pooled estimates. Publication bias was assessed using Egger's and Begg's tests, and meta-regression analysis was performed to explore potential sources of heterogeneity across studies. RESULTS: Seventy-six eligible cohort studies with eight types of sleep disturbances were included in the meta-analysis. Insomnia was associated with an increased risk of dementia (RR = 1.13). Both short sleep duration (7 h; RR = 1.27) and long sleep duration (8 h; RR = 1.23 for cognitive decline, RR = 1.43 for all-cause dementia, and RR = 1.66 for Alzheimer's disease (AD) were significant risk factors for cognitive decline and dementia. Excessive daytime sleepiness significantly increased the risks of vascular dementia (VD) (RR = 1.85), all-cause dementia (RR = 1.41), and cognitive decline (RR = 1.37). Sleep-related movement disorders indicated the strongest association, markedly increasing the risk of VD (RR = 2.53). Poor sleep quality was also a significant risk factor for AD (RR = 1.24), all-cause dementia (RR = 1.17), and cognitive decline (RR = 1.18). CONCLUSION: This meta-analysis highlights sleep management as a pivotal modifiable factor in reducing the risk of all-cause cognitive decline. Systematic screening and early intervention for sleep disturbances should be prioritized as essential preventive strategies in clinical populations.

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