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Sleep disturbances increase the risk of dementia: A systematic review and meta-analysis
Shi L, Chen SJ, Ma MY, Bao YP, Han Y, Wang YM, Shi J, Vitiello MV et al.. Sleep medicine reviews, 2017-07-06
Topic: Risk, prevention and care in population studies
Sleep disturbances and dementia are two common and significant health problems in older adults. Investigations suggest that sleep disturbances might increase the risk of dementia. The aim of the present study was to systematically review and meta-analyze the predictive roles of overall sleep disturbances, their subtypes (e.g., insomnia, sleep disordered breathing [SDB]), and other sleep problems (e.g., excessive daytime sleepiness, sleep-related movement disorder, circadian rhythm sleep disorder, and nonspecific sleep problems) in incident all-cause dementia and Alzheimer's disease (AD) and vascular dementia subtypes. We performed a systematic search of the PubMed, EMBase, ISI Web of Science, and PsycINFO databases for longitudinal studies that were published up to October 28, 2016. A total of 12,926 papers were retrieved. Eighteen longitudinal studies that included 246,786 subjects at baseline and 25,847 dementia cases after an average 9.49 y of follow-up were eligible for inclusion. Compared with individuals without sleep disturbances, subjects who reported sleep disturbances had a higher risk of incident all-cause dementia, AD, and vascular dementia. The subgroup analysis showed that insomnia increased the risk of AD but not vascular or all-cause dementia. In contrast, SDB was associated with a higher incidence of all-cause dementia, AD, and vascular dementia. This meta-analysis suggests that sleep disturbances may predict the risk of incident dementia. Moreover, insomnia was associated only with incident AD, and SDB was a risk factor of all-cause dementia, AD, and vascular dementia. However, sleep disturbances were evaluated mainly based on self-reports, and some confounders may mediate the relationship between sleep disturbances and dementia. Therefore, the results should be further validated. In summary, these findings may help identify individuals who are at risk for dementia and optimize early prevention strategies.
Key findings
- Sleep disturbances and dementia are two common and significant health problems in older adults.
- Investigations suggest that sleep disturbances might increase the risk of dementia.
- The aim of the present study was to systematically review and meta-analyze the predictive roles of overall sleep disturbances, their subtypes (e.g., insomnia, sleep disordered breathing [SDB]), and other sleep problems (e.g., excessive daytime sleepiness, sleep-related movement disorder, circadian rhythm sleep disorder, and nonspecific sleep problems) in incident all-cause dementia and Alzheimer's disease (AD) and vascular dementia subtypes.
- Compared with individuals without sleep disturbances, subjects who reported sleep disturbances had a higher risk of incident all-cause dementia, AD, and vascular dementia.
- The subgroup analysis showed that insomnia increased the risk of AD but not vascular or all-cause dementia.
Why it matters
Pooling 18 long-term studies of 246,786 people, this review found that people who reported sleep problems were more likely to develop dementia later, including Alzheimer's disease and vascular dementia. Insomnia was linked only to Alzheimer's disease, while sleep-disordered breathing was linked to all three outcomes. Sleep was mostly self-reported and confounding could not be ruled out, so this shows a link that can help flag risk, not proof that sleep problems cause dementia or that treating them prevents it.
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Study details
- Study designmeta-analysis
- Participants246,786
- Evidence strengthHigh
How this study scored 78/100
Published in a peer-reviewed journal, and it is a meta-analysis pooling many studies. Scored zero for effect reported because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Sleep medicine reviews) |
| Journal's citation record | 2 / 4 | Sleep Medicine Reviews: journal h-index 227 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A meta-analysis pooling many studies |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2018 — within 10 year(s) of the newest study here |
| Sample size | 4 / 4 | 246,786 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | 6 / 7 | Cited 996 times (OpenAlex, 2026-10-10) |
| Citations per year | 5 / 5 | 99.6 citations a year over 10 year(s) since 2018 |
| Impact for its field and year | 4 / 6 | Cited 9.3× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 4 / 6 | Cited by 46 other studies in this library |
| Still being cited | 4 / 4 | Cited 446 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Lin Lü: h-index 89 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | University of Washington: institution h-index 3,540 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 6 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 28890168) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 78 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Shi, L., Chen, S. J., Ma, M. Y., Bao, Y. P., Han, Y., Wang, Y. M., et al. (2018). Sleep disturbances increase the risk of dementia: A systematic review and meta-analysis. Sleep medicine reviews. https://doi.org/10.1016/j.smrv.2017.06.010
Vancouver
Shi L, Chen SJ, Ma MY, Bao YP, Han Y, Wang YM, et al. Sleep disturbances increase the risk of dementia: A systematic review and meta-analysis. Sleep medicine reviews. 2018. doi:10.1016/j.smrv.2017.06.010. PMID: 28890168.
BibTeX
@article{shi2018-28890168,
author = {Shi, L. and Chen, S. J. and Ma, M. Y. and Bao, Y. P. and Han, Y. and Wang, Y. M. and Shi, J. and Vitiello, M. V. and others},
title = {{Sleep disturbances increase the risk of dementia: A systematic review and meta-analysis}},
journal = {Sleep medicine reviews},
year = {2018},
doi = {10.1016/j.smrv.2017.06.010},
pmid = {28890168},
url = {https://doi.org/10.1016/j.smrv.2017.06.010}
}
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