Sleep, Cognitive impairment, and Alzheimer's disease: a systematic review and meta-analysis
Abstract
Study Objectives: Mounting evidence implicates disturbed sleep or lack of sleep as one of the risk factors for Alzheimer's disease (AD), but the extent of the risk is uncertain. We conducted a broad systematic review and meta-analysis to quantify the effect of sleep problems/disorders on cognitive impairment and AD. Methods: Original published literature assessing any association of sleep problems or disorders with cognitive impairment or AD was identified by searching PubMed, Embase, Web of Science, and the Cochrane library. Effect estimates of individual studies were pooled and relative risks (RR) and 95% confidence intervals (CI) were calculated using random effects models. We also estimated the population attributable risk. Results: Twenty-seven observational studies (n = 69216 participants) that provided 52 RR estimates were included in the meta-analysis. Individuals with sleep problems had a 1.55 (95% CI: 1.25-1.93), 1.65 (95% CI: 1.45-1.86), and 3.78 (95% CI: 2.27-6.30) times higher risk of AD, cognitive impairment, and preclinical AD than individuals without sleep problems, respectively. The overall meta-analysis revealed that individuals with sleep problems had a 1.68 (95% CI: 1.51-1.87) times higher risk for the combined outcome of cognitive impairment and/or AD. Approximately 15% of AD in the population may be attributed to sleep problems. Conclusion: This meta-analysis confirmed the association between sleep and cognitive impairment or AD and, for the first time, consolidated the evidence to provide an "average" magnitude of effect. As sleep problems are of a growing concern in the population, these findings are of interest for potential prevention of AD.
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Sleep disturbances were associated with higher risk of all-cause dementia and clinically diagnosed Alzheimer's disease compared with no sleep disturbance.
“All these disturbances were associated with a higher risk of all-cause dementia (RR 1·2; 95% CI 1·1–1·3)137 and clinically diagnosed Alzheimer's disease (1·6, 1·3–1·9) compared with no sleep disturbance, although not all cohort studies excluded those with cognitive impairment or dementia at baseline from their analyses.”
From Dementia prevention, intervention, and care: 2020 report of the Lancet Commission (2020) · cites this paper as [138]
Sleep disorders increase AD risk, and about 15% of AD cases may be attributed to sleep problems.
“Mounting evidence suggests that sleep disorders increase AD risk [560–562], and about 15% of AD cases may be attributed to sleep problems [560].”
From Molecular and cellular mechanisms underlying the pathogenesis of Alzheimer’s disease (2020) · cites this paper as [560]
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- Authors
- Bubu, O. M., Brannick, M., Mortimer, J., Umasabor-Bubu, O., Sebastião, Y. V., Wen, Y., Schwartz, S., Borenstein, A. R., Wu, Y., Morgan, D., & Anderson, W. M.
- Affiliations
- University of South Florida (US)
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 2016-12-09
- Volume
- 40
- Issue
- 1
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- OpenAlex
- W2547784142
- Cited by
- 673
- References
- 71
- Citations by year
- 2026: 80 · 2025: 100 · 2024: 116 · 2023: 84 · 2022: 80 · 2021: 73 · 2020: 62 · 2019: 44 · 2018: 19 · 2017: 14 · 2012: 1
- FWCI
- 3.66
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- SLEEP (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Keywords
- sleep disorders, Alzheimer's disease, cognitive impairment, preclinical Alzheimer's disease, risk factors, population attributable risk, dementia prevention
- MeSH terms
- Alzheimer Disease, Humans, Risk Factors, Sleep Wake Disorders, Cognitive Dysfunction
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