Effect of Creatine Supplementation on Sleep-Deprived Individuals: A Systematic Review

Background: Sleep deprivation impairs executive function through the disruption of cerebral energy homeostasis. Creatine supplementation may mitigate these effects by enhancing phosphocreatine availability and supporting adenosine triphosphate regeneration during periods of sleep deprivation. Objective: We aimed to systematically review the evidence evaluating the effects of creatine supplementation on executive function during sleep deprivation. Methods: A systematic search of PubMed, Scopus, and Web of Science was conducted from database inception to June 2026. Randomized controlled trials evaluating creatine supplementation in sleep-deprived adults and reporting quantitative executive function metrics were eligible for inclusion. Data extraction and risk of bias assessment were performed independently by two reviewers. Results: Five eligible publications representing four independent randomized controlled trial cohorts (82 analysed participants) were included. Creatine supplementation was associated with improvements in selected executive-function measures, particularly logical reasoning, working memory and central executive tasks, although effects varied across cognitive domains. Neuroimaging findings from one cohort, reported in two publications, indicated alterations in cerebral high-energy phosphate metabolism and reduced hemispheric metabolic asymmetry following creatine administration. Conclusions: Creatine supplementation may attenuate selected executive-function impairments during acute sleep deprivation, although the evidence is limited by small samples, methodological heterogeneity and overlapping publications. Larger randomized trials using standardized sleep-deprivation protocols and cognitive outcome measures are required to confirm efficacy and determine optimal dosing strategies.