OBJECTIVES: Insomnia transcends individual well-being, emerging as a prominent risk factor for developing or poor prognosis of high-impact pathologies. We aim to describe the current burden of insomnia, exploring its relevance in relation to other high-impact pathologies.

METHODS: A systematic literature review was conducted in Pubmed/Medline to identify studies examining insomnia’s association or burden with other high-impact pathologies (COVID-19, cancer survivors, cardiometabolic diseases, neurodegenerative diseases, and mental illness). Observational studies, reviews, and meta-analyses evaluating insomnia using established diagnostic criteria, conducted in Europe, United States and Canada, and published in Spanish/English between 2017-2023 were included. Clinical trials, opinion articles, letters to the editor, conference proceedings, and studies focused on specific populations and/or lacking stablished insomnia diagnostic criteria were excluded. The Oxford Center for Evidence-Based Medicine levels of evidence was employed to assess the evidence level and quality of the studies reviewed.

RESULTS: Sixteen publications were included; observational studies (81%), narrative reviews (13%), systematic review (6%); evidence levels: 1b (38%), 2a (13%), 2b (3%), 3a (6%), and 3b (6%).

Insomnia’s relationship with COVID-19 pandemic was evaluated in two studies, revealing up to 50% increased prevalence and significant sleep quality deterioration.

Nine studies assessed insomnia’s relationship to cardiometabolic disease, identifying insomnia as a risk factor for developing heart failure, cardiovascular disease, high blood pressure and metabolic syndrome. Insomnia exhibits a bidirectional association with type 2 diabetes.

Insomnia’s burden in cancer survivors was evaluated in two studies, establishing a 17.4% prevalence and association with poorer neurocognitive performance.

One study showed thatIn Alzheimer’s disease, insomnia was associated to increased economic impact in Alzheimer’s disease.

Three studies reported bidirectional relationship between insomnia and anxiety/depression.

CONCLUSIONS: Insomnia is associated with the development of several high-impact diseases. Early identification and optimal management of insomnia symptoms are crucial for prevention.