Abstract Introduction Sleep loss impairs overall health and cognitive performance, including memory, attention, and executive function that is important for decision-making and risk assessment. In many high-demand occupations such as prolonged shift work, first responders, or military deployment, adequate sleep is often unattainable. The consequences of sleep loss in these professions are still high-stakes and are associated with accidents, workplace injuries, absenteeism, and long-term medical and psychiatric comorbidities. This highlights the need for simple, immediate treatment approaches to mitigate these effects, particularly when behavioral strategies that may take more time and effort are unfeasible. Our systematic review examines the current evidence on the use of creatine, an established ergogenic aid for strength performance and recovery, as a potential means of supporting cognitive function during periods of sleep loss. Methods We performed a systematic review to identify double blind, placebo-controlled studies in English assessing the effects of creatine supplementation on cognitive performance during sleep loss in healthy participants. The studies included in this review were identified through a search of PubMed, Web of Science, and PsycInfo. Two reviewers independently screened studies and resolved discrepancies by consensus. Results Of the 169 studies reviewed, only five met the inclusion criteria, which required a randomized controlled design, at least one cognitive performance outcome, and healthy participants experiencing some degree of sleep loss. In the included trials, participants underwent 3- 35 hours of sleep loss and received either a single creatine dose adjusted for body weight or a 7-day loading protocol. Cognitive performance outcomes varied across studies, but all reported modest improvements associated with creatine supplementation. Conclusion Collectively, these findings suggest that creatine may offer modest cognitive benefits during sleep loss, with the most consistent effects appearing at longer durations of sleep loss. However, confidence in these conclusions is limited due to small sample sizes, differing dosing protocols, wide variation in amount of sleep loss, and the diverse cognitive performance tasks used across studies. The limited number of studies that address the impact of creatine on cognitive performance highlight the need for additional studies in this area, especially in light of favorable outcomes. Support (if any)
Robertson et al. (Fri,) studied this question.