Sleep and Blood-Brain Barrier Integrity - Current Understanding and Biological Mechanisms: Literature Review
DOI:
https://doi.org/10.12775/JEHS.2025.86.66821Keywords
blood-brain barrier, sleep, sleep deprivation, sleep loss, circadian rhythm, glymphatic system, oxidative stress, obstructive sleep apnea syndromeAbstract
Background: The blood-brain barrier (BBB) maintains central nervous system homeostasis through the coordinated activity of endothelial cells, pericytes, astrocytes, and other components of the neurovascular unit (NVU). Both sleep and circadian rhythms are critical for preserving BBB integrity.
Aim This review summarizes current understanding of the relationship between sleep and blood-brain barrier function, with particular focus on cellular and molecular mechanisms, and the clinical consequences of sleep disorders.
Material and methods: Articles published between 2010 and 2025 were selected, with earlier publications included when relevant. The search employed the keywords: “blood-brain barrier,” “sleep,” “sleep deprivation,” “sleep loss,” “circadian rhythm,” “glymphatic system,” “oxidative stress,” and “obstructive sleep apnea syndrome.” Sources included PubMed, Google Scholar, and ScienceDirect. Sixty-nine studies were chosen based on relevance, and quality of evidence.
Results: Recent studies demonstrate that optimal sleep architecture plays a regulatory role in the neurovascular unit (NVU). Sleep deprivation and circadian rhythm disturbances have been shown to increase blood-brain barrier (BBB) permeability, induce oxidative stress, impair the glymphatic system, promote persistent low-grade inflammation, and lead to the accumulation of neurotoxic metabolites. Collectively, these changes may accelerate the progression of neurodegenerative diseases.
Conclusion: These findings suggest that maintaining normal sleep patterns and stable circadian rhythms is essential for preserving neurovascular homeostasis and preventing brain degeneration. More translational and clinical research is needed to identify therapeutic targets. Further studies must also clarify the long-term effects of sleep disruption on BBB function and overall brain health.
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