Association between sleep quality and cancer-related cognitive impairment in patients with cancer: a meta-analysis.

Abstract

<h4>Objectives</h4>This meta-analysis aimed to systematically evaluate and synthesize existing evidence to elucidate the association between sleep quality and cancer-related cognitive impairment (CRCI).<h4>Methods</h4>PubMed, Embase, Scopus, Web of Science, China National Knowledge Infrastructure (CNKI), China Biology Medicine Disc (CBM), Wanfang data, and the VIP Journal Resource Integration Service Platform (VIP) were systematically searched inception to July 2025. The quality of the literature was evaluated using the Newcastle-Ottawa Scale and the Joanna Briggs Institute Cross-sectional Study Evaluation Checklist. The effect size <i>r</i> was transformed into Fisher's <i>z</i>-values for statistical analysis. The combined analysis was performed using Fisher's <i>z</i>-values and its standard error, and then the combined <i>z</i>-values were converted back to <i>r</i> for the discussion of the results. Statistical analyses were performed using Stata v.18.0.<h4>Results</h4>A total of 4,037 articles were retrieved, and 13 articles (2,908 participants) were selected for further analysis. The meta-analysis based on the correlation coefficient <i>r</i> revealed a significant association between sleep quality and CRCI, with a correlation coefficient of <i>r</i> = -0.44 (95% CI: -0.55, -0.32). Sensitivity analysis confirmed the robustness of the (<i>r</i> = -0.47 to -0.40), and publication bias was not detected (<i>p</i> = 0.410). A supplementary meta-analysis of six studies using standardized regression coefficients further supported this association (<i>β</i> = -0.28, 95% <i>CI</i>: -0.34 to -0.22).<h4>Conclusion</h4>Studies have found a moderate negative correlation between sleep quality and CRCI, suggesting that poorer sleep quality is associated with more severe cognitive impairment.<h4>Systematic review registration</h4>PROSPERO RD420251090655.