Deep Brain Stimulation for Sleep-Wake Regulation: A Narrative Review

Area of Science:

• Neuromodulation
• Sleep Science
• Neuroscience

Background:

• Sleep-wake disorders frequently co-occur with neurological and psychiatric conditions.
• Current treatments for sleep-wake disorders offer incomplete efficacy.
• The subcortical regulation of sleep suggests invasive stimulation as a potential therapeutic avenue.

Purpose of the Study:

• To review preclinical and clinical evidence on deep brain stimulation (DBS) and similar invasive stimulation techniques for sleep-wake (SW) control.
• To explore the effects of stimulating both SW-related and non-SW-related brain targets on sleep and wakefulness.
• To address key questions regarding brain areas, stimulation parameters, and challenges in using invasive neuromodulation for SW disorders.

Main Methods:

• Narrative review of existing preclinical and clinical studies.
• Synthesis of evidence on the impact of DBS and invasive stimulation on sleep architecture and arousal.
• Analysis of target- and frequency-dependent effects of stimulation.

Main Results:

• Invasive stimulation, including DBS, can modulate sleep architecture and arousal.
• Stimulation effects are dependent on the targeted brain region and stimulation frequency.
• Translational success has been observed in conditions like Parkinson's Disease and Obsessive-Compulsive Disorder.

Conclusions:

• Deep brain stimulation (DBS) offers a promising therapeutic strategy for sleep-wake disturbances.
• Standardized polysomnography and advanced targeting are crucial for optimizing DBS outcomes.
• Invasive neuromodulation holds potential for both treating SW disorders and advancing our understanding of sleep-wake dynamics.