Long Sleep and Insomnia are Associated with Reduced Global Cognitive Function across Diverse Populations
Abstract
Background: Although sleep disorders are generally associated with cognitive decline, definitions of sleep conditions and cognitive function vary greatly across studies. Therefore, we evaluated associations between consensus definitions of sleep and cognitive outcomes across multiple studies. Methods: Consensus sleep measures were ascertained at baseline visits in three cohort studies (HCHS/SOL, MESA and ARIC, N=11,563): short and long sleep ([≤]6hours and [≥]9hours), insomnia (Women's Health Initiative Insomnia Rating Scale [≥]10 or [≥]6 for 3 questions), daytime sleepiness (Epworth Sleepiness [≥]11) and obstructive sleep apnea (OSA, Apnea-Hypopnea Index [≥]15). Cognitive measures were ascertained at baseline and follow-up visits in each study and used to calculate harmonized outcomes: global cognitive function (GCF) at baseline, change in GCF between baseline and follow-up, poor GCF at baseline ([≥]1SD below the median), and incident poor GCF at follow-up. Study-specific analyses were adjusted for age, sex, center, education, race/ethnicity, APOE4 and language of cognitive assessments as needed. Results were meta-analyzed across studies. Results: Long sleep was consistently associated with lower baseline GCF ({beta}=-0.19, SE=0.03, p=3.78x10-14, FDR p=7.56x10-13, p-heterogeneity=0.78) and increased odds of poor baseline GCF (OR=1.77, 95% CI=1.49-2.09, p=2.96x10-11, FDR p=2.96x10-10, p-heterogeneity=0.22) across cohorts. Insomnia was also suggestively associated with lower baseline GCF ({beta}=-0.051, SE=0.02, p=0.01, FDR p=0.07, p-heterogeneity=0.005) and increased odds of poor baseline GCF (OR=1.22, 95% CI=1.06-1.41, p=6.76x10-3, FDR p=0.05, p-heterogeneity=0.03). Sleep measures were not associated with change in cognitive function. Discussion: Associations of long sleep and insomnia with harmonized cross-sectional GCF across three large, multiethnic cohorts suggest that cognitive function may be associated with distinct sleep phenotypes.
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BibTeX
@misc{wyss2026long,
title = {{Long Sleep and Insomnia are Associated with Reduced Global Cognitive Function across Diverse Populations}},
author = {Annah B. Wyss and Yu Zhang and Michael R. Brown and Jan Bressler and Charles DeCarli and Myriam Fornage and Hector M. González and Xiuqing Guo and Susan R. Heckbert and Timothy M. Hughes and Carmen R. Isasi and Sonya S. Kaur and Melissa Lamar and Peter Y. Liu and Pamela L. Lutsey and Alanna C. Morrison and Qibin Qi and Alberto R. Ramos and Susan Redline and Jerome I. Rotter and Chloé Sarnowski and Daniela Sotres-Alvarez and Wassim Tarraf and Kent D. Taylor and Meredith J. Wallace and Alexis C. Wood and Tamar Sofer},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.19.26365906},
url = {https://www.medrxiv.org/content/10.64898/2026.10.19.26365906v1},
note = {CC BY-NC-ND},
}
RIS
TY - UNPB
TI - Long Sleep and Insomnia are Associated with Reduced Global Cognitive Function across Diverse Populations
AU - Annah B. Wyss
AU - Yu Zhang
AU - Michael R. Brown
AU - Jan Bressler
AU - Charles DeCarli
AU - Myriam Fornage
AU - Hector M. González
AU - Xiuqing Guo
AU - Susan R. Heckbert
AU - Timothy M. Hughes
AU - Carmen R. Isasi
AU - Sonya S. Kaur
AU - Melissa Lamar
AU - Peter Y. Liu
AU - Pamela L. Lutsey
AU - Alanna C. Morrison
AU - Qibin Qi
AU - Alberto R. Ramos
AU - Susan Redline
AU - Jerome I. Rotter
AU - Chloé Sarnowski
AU - Daniela Sotres-Alvarez
AU - Wassim Tarraf
AU - Kent D. Taylor
AU - Meredith J. Wallace
AU - Alexis C. Wood
AU - Tamar Sofer
PY - 2026
DA - 2026/10/19
PB - medRxiv
DO - 10.64898/2026.10.19.26365906
UR - https://www.medrxiv.org/content/10.64898/2026.10.19.26365906v1
AB - Background: Although sleep disorders are generally associated with cognitive decline, definitions of sleep conditions and cognitive function vary greatly across studies. Therefore, we evaluated associations between consensus definitions of sleep and cognitive outcomes across multiple studies. Methods: Consensus sleep measures were ascertained at baseline visits in three cohort studies (HCHS/SOL, MESA and ARIC, N=11,563): short and long sleep ([≤]6hours and [≥]9hours), insomnia (Women's Health Initiative Insomnia Rating Scale [≥]10 or [≥]6 for 3 questions), daytime sleepiness (Epworth Sleepiness [≥]11) and obstructive sleep apnea (OSA, Apnea-Hypopnea Index [≥]15). Cognitive measures were ascertained at baseline and follow-up visits in each study and used to calculate harmonized outcomes: global cognitive function (GCF) at baseline, change in GCF between baseline and follow-up, poor GCF at baseline ([≥]1SD below the median), and incident poor GCF at follow-up. Study-specific analyses were adjusted for age, sex, center, education, race/ethnicity, APOE4 and language of cognitive assessments as needed. Results were meta-analyzed across studies. Results: Long sleep was consistently associated with lower baseline GCF ({beta}=-0.19, SE=0.03, p=3.78x10-14, FDR p=7.56x10-13, p-heterogeneity=0.78) and increased odds of poor baseline GCF (OR=1.77, 95% CI=1.49-2.09, p=2.96x10-11, FDR p=2.96x10-10, p-heterogeneity=0.22) across cohorts. Insomnia was also suggestively associated with lower baseline GCF ({beta}=-0.051, SE=0.02, p=0.01, FDR p=0.07, p-heterogeneity=0.005) and increased odds of poor baseline GCF (OR=1.22, 95% CI=1.06-1.41, p=6.76x10-3, FDR p=0.05, p-heterogeneity=0.03). Sleep measures were not associated with change in cognitive function. Discussion: Associations of long sleep and insomnia with harmonized cross-sectional GCF across three large, multiethnic cohorts suggest that cognitive function may be associated with distinct sleep phenotypes.
ER -