0170 Insomnia and Impulsivity: A Systematic Review and Meta-analysis

Abstract Introduction Growing evidence indicates that sleep disturbances are associated with impaired cognitive control, resulting in an increased risk for impulsive behaviors and risk-taking. However, the findings remained mixed and a synthesis of the evidence focusing on insomnia symptoms while including holistic measurements of impulsivity is lacking. This systematic review and meta-analysis aimed to examine whether insomnia symptoms are associated with impulsivity. Methods The review was performed following PRISMA guidelines. Four electronic databases, PubMed, Web of Science, Embase, and PsychINFO were systematically searched from inception to December 2022. Studies were included if they reported the correlation between quantitative measures of insomnia symptoms and impulsivity. Excluded studies were case reports, dissertations, reviews, or conference abstracts. Subgroup analyses were performed to determine whether different populations and measures of impulsivity affected the strength of the association. Data were pooled using the random-effects model and heterogeneity was quantified using I2. Results Across the 42 eligible studies, involving 17091 subjects (59% female; mean age 33 years), there was a significant positive association between insomnia symptoms and impulsivity (r= 0.16, 95% CI, 0.09- 0.24, p < 0.01). Subgroup analyses showed that impulsivity, as measured by self-report, was positively associated with insomnia symptoms (r = 0.22, 95% CI, 0.15- 0.29, p< 0.01), but this association was not found based on the behavioral measures of impulsivity (r = -0.11, 95% CI, -0.30- 0.09, p = 0.28). Meta-regression suggested that publication year was a significant moderator, with studies published more recently showing smaller effect sizes. Conclusion Our findings demonstrate that insomnia symptoms are associated with higher levels of self-reported impulsivity. This points to a crucial next step in clinical practices to target insomnia as a modifiable factor to reduce impulsivity and risk-taking behaviors. Future studies should evaluate this association using samples with a clinical diagnosis of insomnia, with behavioral measures of impulsivity. Furthermore, neuroimaging techniques could be incorporated to unveil the underlying neural mechanisms between impulsivity and insomnia. Support (if any) This work was funded by General Research Fund (Ref. 17619123), Research Grants Council, University Grants Committee, Hong Kong SAR, China.