Sleep disorders and the risk of cognitive decline or dementia: an updated systematic review and meta-analysis of longitudinal studies
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).…
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Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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