This umbrella systematic review evaluated insomnia as a risk factor for dementia, stroke, depression, suicide, death, occupational injuries, and hospitalization, synthesizing 16 existing systematic reviews with meta-analyses (SRMAs) and conducting 3 original SRMAs (stroke, occupational injuries, hospitalization); searches covered MEDLINE and EMBASE through August 2025.
Insomnia was consistently identified as a predictor of dementia, depression, and suicide; it predicted stroke (9 studies, n=1,343,164, HR=1.26, 95%CI 1.05–1.53) and hospitalization for any reason (5 studies, n=517,620, OR=1.28, 95%CI 1.14–1.43); death was not associated with insomnia, and evidence for occupational injuries was insufficient to draw conclusions.
Only two studies (n=143,942) were available for occupational injuries, preventing meta-analysis; the review relies on the quality and heterogeneity of included SRMAs; causal direction cannot be fully established from observational data.
Clinicians should recognize insomnia as a modifiable risk factor linked to stroke, dementia, depression, and hospitalization, and consider proactive screening and treatment of insomnia as part of broader brain and general health care.
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