{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T00:59:17Z","timestamp":1793753957831,"version":"4.6.1"},"reference-count":40,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2019,12,26]],"date-time":"2019-12-26T00:00:00Z","timestamp":1577318400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Neurol Neurosurg Psychiatry"],"accepted":{"date-parts":[[2019,12,11]]},"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To conduct an updated systematic review and meta-analysis of association between sleep and all-cause cognitive disorders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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\u2013response meta-analysis for sleep duration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>11\u2009155 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Sleep management might serve as a promising target for dementia prevention.<\/jats:p><\/jats:sec>","DOI":"10.1136\/jnnp-2019-321896","type":"journal-article","created":{"date-parts":[[2019,12,26]],"date-time":"2019-12-26T22:19:16Z","timestamp":1577398756000},"page":"236-244","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":310,"title":["Sleep problems and risk of all-cause cognitive decline or dementia: an updated systematic review and meta-analysis"],"prefix":"10.1136","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3310-5875","authenticated-orcid":false,"given":"Wei","family":"Xu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen-Chen","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan-Juan","family":"Zou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi-Peng","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lan","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,12,26]]},"reference":[{"key":"2024111108100639000_91.3.236.1","doi-asserted-by":"crossref","first-page":"P390","DOI":"10.1016\/j.jalz.2015.06.326","article-title":"Difficulties falling asleep is associated with higher Abeta burden in healthy adults","volume":"11","author":"Branger","year":"2015","journal-title":"Alzheimers Dement"},{"key":"2024111108100639000_91.3.236.2","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1002\/ana.25117","article-title":"Effect of sleep on overnight cerebrospinal fluid amyloid \u03b2 kinetics","volume":"83","author":"Lucey","year":"2018","journal-title":"Ann Neurol"},{"key":"2024111108100639000_91.3.236.3","first-page":"S53","article-title":"Sleep loss increases risk of Alzheimer's disease by increasing CNS ab production","volume":"82","author":"Lucey","year":"2017","journal-title":"Ann Neurol"},{"key":"2024111108100639000_91.3.236.4","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1001\/jamaneurol.2018.0049","article-title":"Association of excessive daytime sleepiness with longitudinal \u03b2-amyloid accumulation in elderly persons without dementia","volume":"75","author":"Carvalho","year":"2018","journal-title":"JAMA Neurol"},{"key":"2024111108100639000_91.3.236.5","first-page":"P1124","article-title":"Sleep disordered breathing, ApoE4 and \u03b2-amyloid deposition in cognitively normal elderly","volume":"13","author":"Shim","year":"2017","journal-title":"Alzheimers Dement"},{"key":"2024111108100639000_91.3.236.6","doi-asserted-by":"crossref","unstructured":"D\u00edaz M , Pul\u00f3pulos M , Baquero M , et al . Sleep disorders in mild cognitive impairment. Alzheimers Dement 2017;13.doi:10.1016\/j.jalz.2017.06.2015","DOI":"10.1016\/j.jalz.2017.06.2015"},{"key":"2024111108100639000_91.3.236.7","doi-asserted-by":"crossref","unstructured":"Hooghiemstra AM , Visser PJ , Slot RER , et al . Alzheimer\u2019s disease patients with osas history have higher csf tau levels. Alzheimers Dement 2016;12.doi:10.1016\/j.jalz.2016.06.2316","DOI":"10.1016\/j.jalz.2016.06.2316"},{"key":"2024111108100639000_91.3.236.8","doi-asserted-by":"crossref","first-page":"P451","DOI":"10.1016\/j.jalz.2015.06.455","article-title":"Investigating the synergistic relationship between sleep quality, physical activity, and levels of brain beta-amyloid","volume":"11","author":"Brown","year":"2015","journal-title":"Alzheimers Dement"},{"key":"2024111108100639000_91.3.236.9","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1016\/j.jalz.2014.08.104","article-title":"Self-Reported sleep disturbance is associated with Alzheimer's disease risk in men","volume":"11","author":"Benedict","year":"2015","journal-title":"Alzheimer's & Dementia"},{"key":"2024111108100639000_91.3.236.10","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.jalz.2017.06.2269","article-title":"Sleep characteristics and risk of dementia and Alzheimer's disease: the Atherosclerosis risk in Communities study","volume":"14","author":"Lutsey","year":"2018","journal-title":"Alzheimers Dement"},{"key":"2024111108100639000_91.3.236.11","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.1115"},{"key":"2024111108100639000_91.3.236.12","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1212\/WNL.0000000000003732","article-title":"Prolonged sleep duration as a marker of early neurodegeneration predicting incident dementia","volume":"88","author":"Westwood","year":"2017","journal-title":"Neurology"},{"key":"2024111108100639000_91.3.236.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2017.06.010"},{"key":"2024111108100639000_91.3.236.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2010.02.007"},{"key":"2024111108100639000_91.3.236.15","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.15.2008"},{"key":"2024111108100639000_91.3.236.16","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"2024111108100639000_91.3.236.17","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.f7450","article-title":"Converting an odds ratio to a range of plausible relative risks for better communication of research findings","volume":"348","author":"Grant","year":"2014","journal-title":"BMJ"},{"key":"2024111108100639000_91.3.236.18","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.d549","article-title":"Interpretation of random effects meta-analyses","volume":"342","author":"Riley","year":"2011","journal-title":"BMJ"},{"key":"2024111108100639000_91.3.236.19","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.5"},{"key":"2024111108100639000_91.3.236.20","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1097\/XEB.0000000000000132","article-title":"The robust error meta-regression method for dose-response meta-analysis","volume":"16","author":"Xu","year":"2018","journal-title":"Int J Evid Based Healthc"},{"key":"2024111108100639000_91.3.236.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmpb.2009.11.005"},{"key":"2024111108100639000_91.3.236.22","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.1080\/13607863.2017.1387760","article-title":"Psychosocial risk factors and Alzheimer's disease: the associative effect of depression, sleep disturbance, and anxiety","volume":"22","author":"Burke","year":"2018","journal-title":"Aging Ment Health"},{"key":"2024111108100639000_91.3.236.23","doi-asserted-by":"publisher","DOI":"10.1007\/BF03033815"},{"key":"2024111108100639000_91.3.236.24","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.5665\/sleep.2070","article-title":"Excessive sleepiness is predictive of cognitive decline in the elderly","volume":"35","author":"Jaussent","year":"2012","journal-title":"Sleep"},{"key":"2024111108100639000_91.3.236.25","doi-asserted-by":"crossref","first-page":"239","DOI":"10.3233\/JAD-180055","article-title":"Subjective sleep quality is not associated with incident dementia: the Rotterdam study","volume":"64","author":"Lysen","year":"2018","journal-title":"J Alzheimers Dis"},{"key":"2024111108100639000_91.3.236.26","doi-asserted-by":"crossref","unstructured":"Gabelle A , Gutierrez L-A , Jaussent I , et al . Excessive sleepiness and longer nighttime in bed increase the risk of cognitive decline in frail elderly subjects: the MAPT-sleep study. Front Aging Neurosci 2017;9.doi:10.3389\/fnagi.2017.00312","DOI":"10.3389\/fnagi.2017.00312"},{"key":"2024111108100639000_91.3.236.27","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1159\/000431311","article-title":"Daytime sleepiness and sleep inadequacy as risk factors for dementia","volume":"5","author":"Tsapanou","year":"2015","journal-title":"Dement Geriatr Cogn Dis Extra"},{"key":"2024111108100639000_91.3.236.28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2013.09.007"},{"key":"2024111108100639000_91.3.236.29","doi-asserted-by":"publisher","DOI":"10.2174\/15672050113109990134"},{"key":"2024111108100639000_91.3.236.30","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1002\/ana.25166","article-title":"Sleep and cognitive decline: a prospective nondemented elderly cohort study","volume":"83","author":"Suh","year":"2018","journal-title":"Ann Neurol"},{"key":"2024111108100639000_91.3.236.31","doi-asserted-by":"crossref","unstructured":"Lu Y , Sugawara Y , Zhang S , et al . Changes in sleep duration and the risk of incident dementia in the elderly Japanese: the Ohsaki cohort 2006 study. Sleep 2018;41.doi:10.1093\/sleep\/zsy143","DOI":"10.1093\/sleep\/zsy143"},{"key":"2024111108100639000_91.3.236.32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jagp.2013.04.015"},{"key":"2024111108100639000_91.3.236.33","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1016\/j.jagp.2015.12.002","article-title":"Measures of sleep-wake patterns and risk of mild cognitive impairment or dementia in older women","volume":"24","author":"Diem","year":"2016","journal-title":"Am J Geriatr Psychiatry"},{"key":"2024111108100639000_91.3.236.34","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1212\/WNL.0000000000004373","article-title":"Sleep architecture and the risk of incident dementia in the community","volume":"89","author":"Pase","year":"2017","journal-title":"Neurology"},{"key":"2024111108100639000_91.3.236.35","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1016\/S1474-4422(18)30450-2","article-title":"Implications of sleep disturbance and inflammation for Alzheimer's disease dementia","volume":"18","author":"Irwin","year":"2019","journal-title":"Lancet Neurol"},{"key":"2024111108100639000_91.3.236.36","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.2374"},{"key":"2024111108100639000_91.3.236.37","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1007\/s40520-018-1005-y","article-title":"Non-Linear associations between sleep duration and the risks of mild cognitive impairment\/dementia and cognitive decline: a dose\u2013response meta-analysis of observational studies","volume":"31","author":"Liang","year":"2019","journal-title":"Aging Clin Exp Res"},{"key":"2024111108100639000_91.3.236.38","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.5665\/sleep.5768","article-title":"Sleep duration and subsequent cortical thinning in cognitively normal older adults","volume":"39","author":"Spira","year":"2016","journal-title":"Sleep"},{"key":"2024111108100639000_91.3.236.39","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.3832"},{"key":"2024111108100639000_91.3.236.40","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2013.12.025"}],"container-title":["Journal of Neurology, Neurosurgery &amp; Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jnnp-2019-321896","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T16:10:52Z","timestamp":1731341452000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnnp.bmj.com\/lookup\/doi\/10.1136\/jnnp-2019-321896"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,26]]},"references-count":40,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2020,2,13]]},"published-print":{"date-parts":[[2020,3]]}},"alternative-id":["10.1136\/jnnp-2019-321896"],"URL":"https:\/\/doi.org\/10.1136\/jnnp-2019-321896","relation":{},"ISSN":["0022-3050","1468-330X"],"issn-type":[{"value":"0022-3050","type":"print"},{"value":"1468-330X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12,26]]}}}