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Trouble Falling Asleep May Predict Cognitive Decline, Study Finds

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Key Takeaways

  • Trouble falling asleep predicted poorer episodic memory, executive function, language, and processing speeds.
  • Depression and vascular disease mediate this association.
  • Proper sleep hygeine is an important part of keeping the body and mind healthy into advanced ages.

Most are familiar with the short-term impacts of insomnia. Its long-term impacts are of particular concern in a recent study abstracted in the journal Sleep, which found that trouble falling asleep was linked to cognitive decline.

Given the uncertainty of the pandemic, many have had to attempt new strategies to navigate the challenges of stress-related insomnia.

As the country continues to adapt to ever-changing circumstances as a result of COVID-19, this research has far-reaching implications for the importance of promoting sleep hygiene as a public health concern.

Understanding the Research

For this study, the impact of insomnia symptoms in 2002 on cognitive decline in 2016 was assessed for 2,496 adults aged 51 and over.

Trouble falling asleep was the only predictor of poorer episodic memory, executive function, and language, as mediated by the impacts of self-reported depression, hypertension, heart disease, diabetes, and stroke.

In terms of limitations, a correlation between two variables may be a relevant finding but the mere existence of a relationship does not mean that impaired sleep directly caused the impairment in cognitive functioning.

Sleep Hygiene for Cognitive Health

Chief Psychologist at A Better Life Recovery, Meghan Marcum, PsyD, says, “This study was focused on sleep however there are other factors that also relate to a decline in cognitive functioning (genetics, time spent socializing with others, etc.) and these should also be highlighted for the public.”

Meghan Marcum, PsyD

I have seen many individuals achieve progress toward mental health and overall well-being once they make a commitment to improving their quality of sleep.

— Meghan Marcum, PsyD

Since the general public knows that sleep is necessary to thrive, Marcum admits that this study is not making any revolutionary breakthroughs about how sleep causes Alzheimer's but it does help to identify the warning signs and how sleep is associated with memory and other areas of cognition.

Marcum says, "Sleep can affect our physical and mental health in significant ways. I have seen many individuals achieve progress toward mental health and overall well-being once they make a commitment to improving their quality of sleep. Good sleep hygiene practices are recommended to anyone who wants to live a long and healthy life."

Poor Sleep Impacts Brain Health

Scott Kaiser, MD, a board-certified geriatrician and director of Geriatric Cognitive Health for the Pacific Neuroscience Institute at Providence Saint John’s Health Center, says, "Our sleep health—the quantity, quality, and patterns of our sleep—has a clear impact on our brain health."

Scott Kaiser, MD

It’s high time we as a society prioritize good sleep hygiene, the importance and overall value of a good night’s sleep, and work to assure that people are able to get enough sleep.

— Scott Kaiser, MD

Unfortunately, this critical connection between sleep and brain health remains underappreciated, which is why Kaiser recommends that issues with sleep should be something that is considered for anyone suffering from memory issues or those interested in optimizing their overall brain health and reducing their long-term risk of dementia. "Many studies have identified poor sleep as a risk factor for cognitive issues," he says.

Kaiser says, "I’m often surprised by how many patients I see, including those who are committed to healthy lifestyles, interested in improving the health of their brains, and eager to avoid developing Alzheimer’s disease—who still fail to prioritize their sleep. It’s high time we as a society prioritize good sleep hygiene, the importance and overall value of a good night’s sleep, and work to assure that people are able to get enough sleep."

What This Means For You

As this study found, trouble falling asleep was associated with poorer episodic memory, executive function, language, and processing speeds. The long-term impact of insomnia on cognitive decline is a public health issue that needs to be taken seriously. This is why Kaiser says, "Making this shift, driving public health efforts, changing workplace and school cultures, changing our collective habits, will serve as a critical step towards improving brain health."

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  1. Zaheed A, Spira A, Chervin R, Zahodne L. Insomnia symptoms and subsequent cognitive performance in older adults: are depressive symptoms and vascular disease mediators? Sleep. 2021;44(suppl 2):A212. doi:10.1093/sleep/zsab072.535