Glymphatic-meningeal lymphatic system, a new therapeutic target for sleep disorders

Abstract

Sleep disorders encompass a range of diseases and symptoms that disrupt individual sleep patterns, degrade sleep quality, and diminish sleep efficiency. Currently, the mechanisms governing sleep regulation and the etiology of sleep disorders remain unclear, leading to clinical treatments that are primarily symptomatic due to the absence of precise intervention methods. Recent studies suggest that glymphatic-meningeal lymphatic route is responsible for the clearance of macromolecular metabolites from the brain, thus playing a pivotal role in maintaining sleep homeostasis and circadian rhythm. Brain lymphatic draining may be a new target for early diagnosis, drug development, and precise treatment of sleep disorders. The following scientific issues merit exploration through a profound, cross-disciplinary collaboration between basic and clinical research: the intrinsic link between the polymorphism of aquaporin-4, a glymphatic functional marker, and the occurrence of sleep disorders; the clinical value of glymphatic-meningeal lymphatic draining imaging in early screening for sleep disturbance-related brain impairments; and the feasibility of enhancing glymphatic-meningeal lymphatic drainage in the intervention of sleep disorders.