A systematic review of ambient heat and sleep in a warming climate
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Abstract
Abstract Background Earlier reviews documented the effects of a broad range of climate change outcomes on sleep but have not yet evaluated the effect of ambient temperature. This systematic review aims to identify and summarize the literature on ambient temperature and sleep outcomes in a warming world. Methods For this systematic review, we searched online databases (PubMed, Scopus, JSTOR, GreenFILE, GeoRef and PsycARTICLES) together with relevant journals for studies published before February 2023. We included articles reporting associations between objective indicators of ambient temperature and valid sleep outcomes measured in real-life environments. We included studies conducted among adults, adolescents, and children. A narrative synthesis of the literature was then performed. Findings The present systematic review shows that higher outdoor or indoor ambient temperatures, expressed either as daily mean or night-time temperature, are negatively associated with sleep quality and quantity worldwide. The negative effect of higher ambient temperatures on sleep is stronger in the warmest months of the year, among vulnerable populations and in the warmest areas of the world. This result appears consistent across several sleep indicators and measures. Interpretation Although this work identified several methodological limitations of the extant literature, a strong body of evidence from both this systematic review and previous experimental studies converge on the negative impact of elevated temperatures on sleep quality and quantity. In absence of solid evidence on fast adaptation to the effects of heat on sleep, rising temperatures induced by climate change pose a planetary threat to human sleep and therefore human health, performance and wellbeing.
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Standalone sleep restriction therapy improved sleep efficiency and depressive symptoms in adults with insomnia.
“Meta-analytic evidence supports that standalone sleep restriction therapy improved sleep efficiency and depressive symptoms in adults with insomnia [46]”
From Pre-Sleep Anxiety: Mechanisms and Therapeutic Approaches in Clinical Practice. (2026) · cites this paper as [46]
The Descriptive findings (pp. 15, 22–23) discuss associations between temperature and sleep measures, including sleep efficiency, not treatment for insomnia. A search for standalone sleep restriction therapy and depressive symptoms found no passage reporting the claimed meta-analytic result. (LLM, conf=0.77)
Experimental — accuracy not yet measuredSleep restriction increases homeostatic sleep pressure by limiting time spent in bed to align with actual sleep duration, thereby increasing sleep efficiency.
“Sleep restriction increases homeostatic sleep pressure by limiting time spent in bed to align with actual sleep duration, thereby increasing sleep efficiency [46].”
From Pre-Sleep Anxiety: Mechanisms and Therapeutic Approaches in Clinical Practice. (2026) · cites this paper as [46]
The Adaptation measures section (p. 30) discusses responses to heat, while the Descriptive findings (p. 22) report sleep efficiency in relation to bedroom temperature. Neither addresses sleep restriction therapy, limiting time in bed to match actual sleep duration, or increased homeostatic sleep pressure; searches for those terms found no supporting passage in our copy. (LLM, conf=0.76)
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- Authors
- Chevance, G., Minor, K., Vielma, C., Campi, E., O’Callaghan-Gordo, C., Basagaña, X., Ballester, J., & Bernard, P.
- Affiliations
- Barcelona Institute for Global Health (ES)
- Columbia University (US)
- Universitat Pompeu Fabra (ES)
- Université du Québec à Montréal (CA)
- Corresponding author
- Chevance, Guillaume
- Minor, Kelton
- ORCID
- Venue
- Sleep Medicine Reviews
- Publisher
- Elsevier BV
- Published
- 2024-06
- Volume
- 75
- Pages
- 101915
- ISSN
- 1087-0792 (ISSN-L)
- OpenAlex
- W4392505490
- Cited by
- 150
- References
- 129
- Citations by year
- 2026: 70 · 2025: 58 · 2024: 21 · 2023: 1
- FWCI
- 6.40
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Sleep Medicine Reviews (publishedVersion, cc-by-nc)
- medRxiv (acceptedVersion, cc-by)
- PubMed (publishedVersion)
- HAL (submittedVersion, cc-by-sa)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Repositori digital de la UPF (Universitat Pompeu Fabra) (submittedVersion, cc-by-nc)
- Funders
- European Union
- Generalitat de Catalunya (RYC2021-033537-I, MCIN /AEI/10.13039/501100011033)
- Topics
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Climate Change and Health Impacts
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology › Thermoregulation and physiological responses
- Keywords
- ambient temperature, sleep quality, sleep quantity, climate change, heat exposure, indoor temperature, night temperature, vulnerable populations, urbanization
- MeSH terms
- Sleep Quality, Hot Temperature, Humans, Sleep, Climate Change
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