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ObjectiveTo examine effects of insomnia and its subtypes on incidence of cognitive impairment among elderly residents in China and to provide evidence for developing relevant intervention programs. MethodsThe data on mild cognitive impairment (MCI) and dementia screening and their associates for 10 829 community elderly aged ≥ 65 years were collected from the China Multicentre Dementia Survey (CMDS) and the Hubei Aging and Memory Cohort Study (HAMCS) conducted from 2018 to 2020. Unconditional multivariate logistic regression model was used to analyze the effects of insomnia and its subtypes on MCI and dementia. ResultsOf the 10 829 elderly, 3478 (32.1%) were assessed as having insomnia; 3 191 (29.5%) were identified suffering from MCI; and 865 (8.0%) were diagnosed with dementia. After controlling for gender, age, years of education, marital status, residence, social activities, physical exercise, alcohol drinking, hypertension, diabetes, anxiety or depression, and chronic constipation, multivariate logistic regression analysis revealed following significant risk factors of MCI: insomnia (odds ratio [OR ] = 1.139, 95% confidence interval [95%CI]: 1.033 – 1.256), difficulty in falling asleep (OR = 1.150, 95%CI: 1.023 – 1.294), and excessive daytime sleep (OR = 1.345, 95%CI: 1.051 – 1.722); the analysis also showed that the elderly with excessive daytime sleep were at an increased risk of dementia (OR = 1.984, 95%CI: 1.389 – 2.835). ConclusionIn Chinese elderly, insomnia could increase the risk of cognitive impairment; having difficulty in falling asleep is associated with increased MCI incidence and with excessive daytime sleep is related to high incidence of dementia.