The Healthspan Map · Sleep (Ch6)

Sleep quality (refreshed)

What this is linked to

Where Sleep quality (refreshed) is linked — 24 sources.In the order the Map holds them: strongest evidence first. That is a statement about the evidence, not about what matters most.
Nutrient or leverDirectionStrengthEvidence typeWhat was foundSource
Sleep quality (refreshed)Watch thisModerateRCT / meta-analysisPoor/short sleep and anxiety are bidirectionally linked; better sleep lowers physiological arousal.De Nys et al. 2022 (opens in a new tab)
Sleep quality (refreshed)Watch thisModerateCohort / observationalPoor sleep quality (higher PSQI, fragmentation, daytime dysfunction) independently raises falls via impaired attention and psychomotor speed.Sleep quality & falls nationwide study (PMC8566001) (opens in a new tab)
Sleep quality (refreshed)Watch thisModerateSystematic reviewSleep deprivation impairs attention and working memory; 7-8 h is optimal for cognition.Sleep-cognition overview 2023 (opens in a new tab)
Sleep quality (refreshed)Watch thisStrongEstablished clinicalNon-restorative, fragmented sleep (frequent unnoticed awakenings) leaves people unrefreshed and fatigued despite adequate hours in bed.Excessive daytime sleepiness review (AFP) (opens in a new tab)
Sleep quality (refreshed)Watch thisModerateRCT / meta-analysisInsomnia roughly doubles the risk of developing depression (OR 2.60); a core modifiable risk factor.Baglioni et al. 2011 (opens in a new tab)
Sleep quality (refreshed)Watch thisModerateRCT / meta-analysisNon-restorative sleep is bidirectionally linked with GI symptom flares.Sleep quality & IBS (opens in a new tab)
Sleep quality (refreshed)Watch thisModerateRCT / meta-analysisIrregular sleep is a major migraine trigger; consistent sleep-wake schedules are a cornerstone of prevention.Robblee & Starling 2019, Cleveland Clinic J Med; lifestyle-migraine meta 2024 (opens in a new tab)
Sleep quality (refreshed)Watch thisModerateReview / narrativeIrregular sleep is a major migraine trigger; consistent sleep-wake schedules are a cornerstone of prevention.Robblee & Starling, "SEEDS for success: Lifestyle management in migraine", Cleve Clin J Med 2019 (opens in a new tab)
Sleep quality (refreshed)Watch thisModerateRCT / meta-analysisInsomnia symptoms and disturbed sleep raise hypertension risk; untreated sleep apnea is a major cause of high blood pressure.Sleep/insomnia & hypertension meta (opens in a new tab)
Sleep quality (refreshed)Watch thisModerateReview / narrativeMost muscle repair happens in deep (slow-wave) sleep, when the growth-hormone pulse peaks; fragmented, poor-quality sleep loses deep sleep first and blunts recovery.Sleep & muscle recovery review (opens in a new tab)
Sleep quality (refreshed)Watch thisModerateRCT / meta-analysisUndisturbed, dark sleep drives melatonin, which promotes bone-building osteoblasts and curbs bone-resorbing osteoclasts; poor-quality sleep and light at night suppress it.Melatonin & bone meta (opens in a new tab)
Sleep quality (refreshed)Watch thisEmergingRCT / trialNerve-pain patients have fragmented, unrefreshing sleep; better sleep quality helps pain and function.Neuropathic pain & sleep (opens in a new tab)
Sleep quality (refreshed)Watch thisModerateCohort / observationalFragmented sleep and obstructive sleep apnea are independently associated with lower testosterone, impaired semen quality and erectile dysfunction that improves when OSA is treated.OSA & male reproductive function (PMC12483905) (opens in a new tab)
Sleep quality (refreshed)Watch thisStrongRCT / trialSleep efficiency below 92% predicted 5.5× higher odds of developing a cold after viral exposure, in graded fashion.Sleep habits & susceptibility to the common cold (Cohen, Arch Intern Med 2009) (opens in a new tab)
Sleep quality (refreshed)Watch thisStrongEstablished clinicalPoor sleepers had double the intrinsic skin-ageing score and 30% less skin-barrier recovery at 72 h (higher TEWL).Sleep quality & skin ageing (opens in a new tab)
Sleep quality (refreshed)Watch thisModerateEstablished clinicalPoor sleep quality amplifies amygdala reactivity and perceived stress; good-quality sleep buffers stress sensitivity.Sleep quality & amygdala/perceived stress (opens in a new tab)
Sleep quality (refreshed)Watch thisEmergingReview / narrativePoor sleep quality correlates with elevated TSH/T4 and, via HPA-axis/cortisol activation, can disturb the hypothalamic–pituitary–thyroid axis.Thyroid dysfunction & sleep quality study (PMC11144793) (opens in a new tab)
Sleep quality (refreshed)Watch thisModerateCohort / observationalReduced sleep quality is consistently associated with bothersome tinnitus.Tinnitus & sleep quality (opens in a new tab)
Sleep quality (refreshed)Watch thisModerateRCT / meta-analysisPoor sleep quality and fragmentation (including sleep apnea) worsen insulin sensitivity and raise diabetes risk.Sleep & T2D risk meta (opens in a new tab)
Sleep quality (refreshed)Watch thisModerateReview / narrativeUnrefreshing sleep is the hallmark of OSA, consistently linked to floppy eyelid syndrome, ischemic optic neuropathy, diabetic macular oedema and other retinal changes.Sleep & eye disease review (PMC9544516) (opens in a new tab)
Sleep quality (refreshed)Watch thisStrongRCT / meta-analysisPoor sleep efficiency raises cold susceptibility and CRP/IL-6 (Cohen; AASM consensus).Sleep quality & infection (opens in a new tab)
Sleep quality (refreshed)Watch thisStrongEstablished clinicalPoor sleep quality is strongly associated with fatigue, physical complaints and reduced quality of life.Pittsburgh Sleep Quality Index review (Occupational Medicine 2025) (opens in a new tab)
Sleep quality (refreshed)Watch thisModerateRCT / meta-analysisPoor sleep quality raises risk of depression, anxiety and cognitive dysfunction.Sleep-quality and mental-health meta-analyses (opens in a new tab)
Sleep quality (refreshed)Watch thisModerateSystematic reviewObstructive sleep apnea (fragmented, unrefreshing sleep) is independently associated with kidney impairment and with hepatic steatosis.OSA & renal impairment meta-analysis (PMC7987709) (opens in a new tab)