Systematic review and meta-analysis of glymphatic dysfunction in sleep disorders and cognitive outcomes

Systematic review and meta-analysis of glymphatic dysfunction in sleep disorders and cognitive outcomes

Systematic review and meta-analysis of glymphatic dysfunction in sleep disorders and cognitive outcomes

Ruth Whitehouse

Professor Johannes Boltze

Sleep disorders, including obstructive sleep apnoea (OSA), narcolepsy type 1 (NT1), and sleep deprivation (SD), are linked to dementia and cognitive decline. The glymphatic system, a brain clearance pathway active during slow-wave sleep, has been proposed as a mechanistic link, though its role remains debated. We conducted a systematic review and meta-analysis of preclinical and clinical studies to evaluate associations between sleep disturbances, glymphatic dysfunction, and cognition. Sleep disorders were consistently associated with impaired glymphatic clearance, with the strongest effects in OSA, supported by dose–response and cognitive analyses. These findings highlight sleep disorders as prevalent, treatable, and potentially modifiable risk factors for dementia, underscoring the public health importance of sleep in maintaining brain health.

sleep, glymphatic system, dementia, cognition, obstructive sleep apnoea, sleep deprivation, narcolepsy, neuroscience, meta-analysis, systematic review