People with insomnia are about 26 percent more likely to have a stroke than people who sleep well, according to a new umbrella review published in Sleep Medicine Reviews.
The same review found insomnia was linked to 28 percent higher odds of being admitted to hospital for any cause.
The analysis pooled data from more than 1.3 million people.
It defined insomnia as difficulty falling or staying asleep, together with impaired daytime functioning, despite having enough opportunity to sleep.
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The researchers say roughly one in five adults meets that description.
The findings do not prove that insomnia causes stroke. They show a consistent association after pooling multiple earlier studies.
An umbrella review is a study of existing systematic reviews, treated as one of the strongest tiers of evidence synthesis.
Depression and suicidal behaviors
The study was led by Luca Vignatelli at the IRCCS Istituto delle Scienze Neurologiche di Bologna in Italy.
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His team combined evidence from previous reviews and added three new systematic reviews of its own.
Databases were searched through August 2025.
Alongside the stroke finding, the team reported associations with depression and suicidal behaviors.
The evidence on dementia and Alzheimer's pointed in the same direction, but was inconsistent across studies.
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Findings on vascular dementia were mixed.
Why sleep loss and stroke may travel together
Blood pressure normally dips during sleep.
When sleep is broken or short, that nightly dip is smaller, and blood pressure stays elevated for longer stretches of the day.
The CDC lists that pattern as one of the ways poor sleep raises the risk of heart disease and stroke.
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Sleeping fewer than seven hours a night is linked to higher rates of heart attack, high blood pressure and stroke.
Chronic sleep loss also feeds low-grade inflammation. It pushes people toward habits that hit the heart, including less exercise, more stress and worse eating.
None of that adds up to insomnia causing a stroke on its own, but the mechanisms give the statistical link a plausible biology.
What actually helps chronic insomnia
The American College of Physicians recommends cognitive behavioral therapy for insomnia, known as CBT-I, as the first-line treatment for chronic insomnia in adults.
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CBT-I is a short, structured therapy that retrains sleep habits and the thoughts around bedtime.
It works as well as sleep pills in the short term, and better over the long term.
Sleep medication may be added if CBT-I alone does not work.
The guideline asks patients and doctors to weigh benefits against harms first. Any drug use should be kept short.
If your sleep problems have lasted for months, or if daytime tiredness is affecting how you work or drive, that is the point to raise it with your doctor rather than wait it out.
This article is made and published by Ida-Marie Palm Varbæk, who may have used AI in the preparation.