Professor of the Practice of Law University of Denver Sturm College of Law

Insomnia & Cognitive Impairment

Insomnia is often caused by cognitive intrusion in response to stressful events. 

Insomnia is difficulty falling asleep, staying asleep, or waking up too early and not being able to go back to sleep. When this happens at least three nights a week and for at least three months, it is considered a chronic disorder. 

Research at Penn State on 1,741 participants found that adults with insomnia, who slept 6 or less hours per night, were two times more likely to experience cognitive impairment than those who slept more than 6 hours per night.  The cognitive impairment caused by this level of sleep deficiency can also be an early indicator of dementia risk.  Prior research by these scientists found that adults suffering from insomnia who get less than 6 hours of sleep per night are also at risk of diabetes, heart disease, stroke, and depression. 

Box breathing is a technique that can reduce stress and anxiety.  Inhale through your nose slowly for 4 seconds, hold for 4 seconds, exhale slowly for 4 seconds, and hold for 4 seconds.  Spending a few minutes practicing box breathing empowers your rest-and-digest system, and the more you practice, the more effective the practice can become.  Research has shown that practicing controlled breathing can reduce the stress hormone cortisol.  Regular box breathing can help reduce the cognitive intrusion that interferes with sleep.

Takeaway: Managing stress so that you regularly get more than 6 hours of sleep can protect against cognitive impairment, dementia risk, and depression.  Consider box breathing several times per day to reduce stress.


Julio Fernandez-Mendoza, Evidence for the Etiopathogenesis of Insomnia and its Psychiatric Risk, Sleep (2014),

Zachary Sweger, Insomnia, Sleeping Less Than 6 Hours May Increase Risk of Cognitive Impairment, Medical Xpress, Sept 25, 2020,

Dr. Alexandra Lambert, Changing how you Inhale and Exhale Could Help Reduce Coronavirus Anxiety,, Oct 1, 2020,

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