Major Review Links Insomnia to 26 Percent Higher Stroke Risk and More Hospital Stays

People with insomnia face a 26 percent higher relative risk of stroke and a 28 percent greater chance of being hospitalized for any reason, according to a major review published in the journal Sleep Medicine Reviews in September 2026.

An international research team from Italy, Austria, Germany, and Switzerland conducted the umbrella systematic review. The lead researcher, Luca Vignatelli of the IRCCS Institute of Neurological Sciences in Bologna, analyzed existing data and performed new meta-analyses for stroke, hospitalization, and workplace injuries.

The stroke finding came from a meta-analysis of nine studies covering more than 1.3 million participants. Researchers found a hazard ratio of 1.26, meaning insomnia was associated with a 26 percent higher relative hazard of stroke compared to people without sleep problems.

Medical experts say the link may stem from several pathways. Chronic insomnia can raise cortisol levels, promote inflammation, and increase arterial stiffness and blood pressure. Poor sleep is also tied to weight gain, high cholesterol, and diabetes, all of which raise stroke risk.

Researchers noted the relationship may be bidirectional: people predisposed to stroke may also be more likely to experience sleep problems.

The study did not prove that insomnia directly causes stroke. Researchers pointed to limitations including inconsistent definitions of insomnia across studies and limited data on sleep medication use.

Doctors recommend cognitive behavioral therapy for insomnia, known as CBT-I, as the preferred long-term treatment. Experts say persistent insomnia should be treated as a potential warning sign for broader health concerns, not a minor inconvenience.