Sleep problems and risk of all-cause cognitive decline or dementia: an updated systematic review and meta-analysis

J Neurol Neurosurg Psychiatry. 2020 Mar;91(3):236-244. doi: 10.1136/jnnp-2019-321896. Epub 2019 Dec 26.

Abstract

Objectives: To conduct an updated systematic review and meta-analysis of association between sleep and all-cause cognitive disorders.

Methods: PubMed and EMBASE were searched from inception to 18 February 2019. Cohort studies exploring longitudinal associations of sleep with cognitive decline or dementia were included. The multivariable-adjusted effect estimates were pooled by random-effects models, with credibility assessment. The robust error meta-regression model was used to conduct the dose-response meta-analysis for sleep duration.

Results: 11 155 reports were searched and 51 eligible cohorts with 15 sleep problems were included for our meta-analyses. Ten types of sleep conditions or parameters, including six (insomnia, fragmentation, daytime dysfunction, prolonged latency, rapid eye movement sleep behaviour disorder and excessive time in bed) with moderate-to-high levels of evidence, were linked to higher risk of all-cause cognitive disorders. Furthermore, a U-shaped relationship was revealed for the associations with sleep duration.

Conclusions: Sleep management might serve as a promising target for dementia prevention.

Keywords: Cognitive decline; Dementia; Meta-analysis; Sleep; Systematic review.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Cognitive Dysfunction / epidemiology*
  • Dementia / epidemiology*
  • Humans
  • Sleep Wake Disorders / complications
  • Sleep Wake Disorders / psychology*