Insomnia Linked to Cognitive Decline, Cognitive Impairment
Medically reviewed by Drugs.com
WEDNESDAY, Sept. 10, 2025 -- Insomnia is associated with cognitive decline and risk for cognitive impairment (CI), according to a study published online Sept. 10 in Neurology.
Diego Z. Carvalho, M.D., from the Mayo Clinic in Rochester, Minnesota, and colleagues examined associations between chronic insomnia, longitudinal cognitive outcomes, and brain health in older adults. Cognitively unimpaired older adults who underwent annual neuropsychological assessments were identified; participants had quantified serial imaging outcomes (amyloid-positron emission tomography [PET] burden [centiloid]) and white matter hyperintensities (WMH, percent of intracranial volume).
A total of 2,750 participants were included in global cognition models; Cox models included 2,814 with median follow-up of 5.6 years. The WMH and amyloid-PET models included 1,027 and 561 participants, respectively. The researchers found that insomnia was associated with a faster decline in global cognition scores by 0.011 per year and a significantly increased risk for cognitive impairment (hazard ratio, 1.4). Associations were seen for insomnia with reduced sleep with baseline cognitive performance (β = −0.211), WMH (β = 0.147), and amyloid-PET (β = 10.5) burden. Lower baseline WMH burden was seen for insomnia participants sleeping more than usual (β = −0.142). There was no association observed for insomnia with the rate of WMH or amyloid accumulation over time.
"Insomnia doesn't just affect how you feel the next day -- it may also impact your brain health over time," Carvalho said in a statement. "We saw faster decline in thinking skills and changes in the brain that suggest chronic insomnia could be an early warning sign or even a contributor to future cognitive problems."
Several authors disclosed ties to the biopharmaceutical industry.
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