(Vienna, Austria) Insomnia is associated with a 26% higher risk of stroke and 28% higher odds of hospital admission, according to new research in Sleep Medicine Reviews . The researchers say the findings support recognising insomnia as an important marker of brain, mental and general health. 1
The review, funded by the European Academy of Neurology (EAN), brings together evidence across seven health outcomes. Alongside the increased risk of stroke and hospitalisation, the researchers found that insomnia was associated with depression and suicidal behaviours, while evidence suggested a link with dementia, particularly Alzheimer’s disease.
The findings add to growing evidence that insomnia may have implications extending well beyond poor sleep and daytime functioning. Insomnia involves difficulty falling or staying asleep and impaired daytime functioning, despite adequate opportunity for sleep. A previous meta-analysis estimated that insomnia meeting international diagnostic criteria affects around 22% of the general population. 2
Lead author Luca Vignatelli, IRCCS Istituto delle Scienze Neurologiche di Bologna, Italy, commented, “Insomnia deserves attention as a warning sign of the status of brain and mental health. These findings show that someone with insomnia has an increased risk for dementia or stroke. Insomnia should be recognised and addressed as part of a wider approach to health to reduce the risk of developing such disorders.”
To assess the wider health impact of insomnia, the researchers searched two major medical research databases, MEDLINE and EMBASE, up to August 2025. They combined evidence from existing systematic reviews with three new systematic reviews of primary studies on stroke, occupational injuries and hospitalisation.
For stroke, nine eligible studies were identified, with six included in the meta-analysis. Overall, the systematic review included more than 1.3 million participants. The analysis found that people with insomnia had a 26% higher risk of stroke (HR 1.26; 95% CI 1.05–1.53), although the size of the association varied substantially between studies.
Five studies examined hospitalisation, three of which were included in the meta-analysis. People with insomnia had 28% higher odds of hospital admission for any reason (OR 1.28; 95% CI 1.14–1.43).
Beyond stroke and hospitalisation, the wider evidence linked insomnia with several brain and mental health outcomes. Most reviews found an association between insomnia and all-cause dementia, although findings were not consistent across all studies. Evidence was more consistent for Alzheimer’s disease, while findings for vascular dementia were mixed.
The authors note that the findings should be interpreted in light of differences in how insomnia was defined across studies and the limited consideration of sleep medication use. They also emphasise that the review identifies associations and does not establish that insomnia directly causes the conditions studied. Nevertheless, the findings support greater attention to insomnia in clinical care and the inclusion of sleep disorders and sleep hygiene in health promotion initiatives.
Study author Professor Stefan Seidel concluded, “Sleep should be part of the conversation about brain health at every age. We need to raise awareness of insomnia and its treatment, and make sure sleep is included in health promotion programmes in our communities, schools and workplaces.”
ENDS
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About the Author(s):
Dr. Luca Vignatelli is a neurologist and epidemiologist with expertise in sleep medicine, Parkinson’s disease, epilepsy, methodology and development of systematic reviews and clinical practice guidelines. He is a Senior Researcher in the Epidemiology and Statistics Unit at the IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy, and an Adjunct Professor at the Neurology Specialization School of the University of Ferrara, Italy. He is an active member of the Guideline Production Group of the European Academy of Neurology. He also serves as a member of the Executive Board of the Italian Association of Neuroepidemiology and the Epidemiology and Research Support Committee of the Italian League Against Epilepsy. In addition, he actively collaborates with the International Parkinson and Movement Disorder Society.
Stefan Seidel, MD, PhD, FEAN, is a neurologist, sleep medicine specialist, and Medical Director at Klinik Pirawarth, Austria. His clinical and scientific work focuses on the interplay between sleep and neurological health, with a particular interest in insomnia as a modifiable risk factor for brain health. His research aims to improve the understanding, prevention, and treatment of sleep-related factors that may influence neurological health and disease across the lifespan
About the study:
This umbrella systematic review examined evidence from cohort studies on seven outcome domains: dementia, stroke, depression, suicidal behaviour, mortality, occupational injuries and hospitalisation. Searches of MEDLINE and EMBASE were updated in August 2025. Both insomnia symptoms and insomnia diagnoses were eligible; a minimum symptom duration was not required.
The researchers combined existing systematic reviews with three original systematic reviews. Statistical pooling was possible for stroke and hospitalisation, but not occupational injuries. The protocol was registered with PROSPERO (CRD42021285454). Review quality was assessed using AMSTAR and primary-study quality using the Newcastle–Ottawa Scale. The work followed PRISMA 2020 reporting guidance.
The authors call for future studies to use shared diagnostic criteria, include populations from under-researched regions, examine specific outcome subtypes and better distinguish the effects of insomnia from those of medications used to treat it.
Funding and declarations:
The research was funded by the European Academy of Neurology. The project also received independent scientific grants from Idorsia, Jazz Pharmaceuticals and Takeda, which provided financial support without influencing the study design, data collection, analysis or interpretation. Ulf Kallweit reports participation in advisory board activities for Bioprojet, Pharmanovia and Takeda; the remaining authors declare no conflicts of interest.
About the EAN:
EAN is a non-profit, independent organisation representing more than 45,000 members, as well as 48 European national societies. As a medical society we promote excellence in the practice of general neurology throughout Europe, leading to improved patient care.
We also aim to keep Europe at the forefront of neurological research and maintain its position as one of the world’s leading scientific hotspots in neurology.
Learn more: ean.org
References:
Sleep Medicine Reviews
Insomnia as risk factor for brain, mental and general health consequences: an umbrella systematic review