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Mapping human sleep-state brain function with simultaneous EEG and neuroimaging: A systematic review
Angeliki Pollatou1, Grant Tays2, Lillian Skeiky1
1Uniformed Services, University of the Health Sciences, MD, United States; Walter Reed National Military Medical Center, United States; The Geneva Foundation, United States.
Neuroimage
|July 10, 2026
Summary
This review synthesizes 30 years of simultaneous electroencephalography (EEG) and neuroimaging studies to map brain activity during sleep stages. Findings reveal key brain regions involved in non-REM and REM sleep, advancing our understanding of sleep neurobiology.
Area of Science:
- Neuroscience
- Sleep Science
- Neuroimaging
Background:
- Sleep involves complex brain activity changes across distinct stages, but the neurobiology of these transitions is not well understood.
- Simultaneous electroencephalography (EEG) and neuroimaging techniques (fMRI, PET, NIRS) offer combined temporal and spatial insights into sleep-related brain function.
Purpose of the Study:
- To conduct the first systematic review of simultaneous EEG-neuroimaging studies of human sleep.
- To synthesize findings across different imaging modalities and sleep states.
- To identify convergent and divergent brain activity patterns during sleep stages.
Main Methods:
- Systematic searches across five databases identified 205 eligible studies using simultaneous EEG with fMRI, PET, or NIRS during human sleep.
- Studies were grouped by imaging modality, sleep state (NREM, REM, transitions), sleep manipulation, and population.
- Findings were analyzed for convergent patterns, acknowledging heterogeneity in protocols and analyses.
Main Results:
- EEG-fMRI was the most common modality (n=141), followed by EEG-PET (n=34) and EEG-NIRS (n=26).
- Convergent findings show thalamic, precuneus, and cingulate involvement in NREM sleep.
- REM sleep exhibited increased limbic/paralimbic activity and reduced executive control activity.
Conclusions:
- Simultaneous EEG-neuroimaging provides valuable insights into sleep-state specific brain function.
- Despite methodological challenges like small sample sizes and protocol heterogeneity, this review maps key brain networks across sleep stages.
- Further research is needed to refine methodologies and deepen our understanding of sleep neurobiology.
