Objective To investigate the risk factors for chronic insomnia-related cognitive impairment in the elderly.Methods A total of 107 elderly patients with chronic insomnia were retrospectively screened and divided into cognitive impairment group and non-cognitive impairment group according to the Montreal Cognitive Assessment score. The general clinical data, Insomnia Severity Index, Pittsburgh Sleep Quality Index, Hamilton Depression Scale score, Hamilton Anxiety Scale score, and Dysfunctional Beliefs and Attitudes about Sleep Scale score were compared between the two groups. A multivariate logistic regression analysis was used to explore the independent risk factors for chronic insomnia-related cognitive impairment in the elderly.Results The multivariate logistic regression analysis showed that subjective sleep disturbance (odds ratio[OR]=16.064, P=0.003), sleep latency (OR=10.567, P=0.032), habitual sleep efficiency (OR=21.697, P=0.006), and sleep disorder (OR=24.754, P=0.008) were independent risk factors for chronic insomnia-related cognitive impairment in the elderly.Conclusions Poor subjective sleep quality, long sleep latency, low habitual sleep efficiency, and severe sleep disorder are independent risk factors for cognitive impairment in elderly patients with chronic insomnia.