Insomnia and mortality: A meta-analysis

Sleep Med Rev. 2019 Feb;43:71-83. doi: 10.1016/j.smrv.2018.10.004. Epub 2018 Nov 11.


The purpose of this review was to evaluate the strength of evidence for a relationship between risk of mortality and frequent and ongoing insomnia using a meta-analytic strategy. Seventeen studies, including a total of 36,938,981 individuals followed up for a mean of 11.6 y, reporting the investigation of the association between mortality and frequent (≥3 nights/wk), ongoing (≥1 mo) insomnia were identified. There was no difference in the odds of mortality for those individuals with symptoms of insomnia when compared to those without symptoms (OR = 1.06, 95%CI = 0.61-1.84, p = .84). This finding was echoed in the assessment of the rate of mortality in those with and without symptoms of insomnia using the outcomes of multivariate models, with the most complete adjustment for potential confounders, as reported by the individual studies included in this meta-analysis (HR = 1.07, 95%CI = .96-.1.19, p = .22). Additional analyses revealed a tendency for an increased risk of mortality associated with hypnotic use. The current evidence reinforces the use of cognitive therapy, within a CBTi framework, as a frontline non-pharmacological treatment for insomnia to reassure patients their longevity will not be impacted as a consequence of suffering from insomnia.

Keywords: Death; Insomnia; Mortality; Sleep disturbance.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Cognitive Behavioral Therapy / methods*
  • Humans
  • Hypnotics and Sedatives / therapeutic use
  • Quality of Life
  • Sleep / physiology*
  • Sleep Initiation and Maintenance Disorders / mortality*


  • Hypnotics and Sedatives