The impact of sleep disorders on the development and course of neurological diseases pathophysiological mechanisms and clinical implications

Abstract

Sleep disorders in older adults increase with age, commonly due to increased sleep latency, decreased sleep efficiency, and reduced total sleep time. The main clinical manifestations are insomnia and excessive daytime sleepiness, which often cause significant distress or impair mental, physical, social, or occupational functioning. Sleep disorders are an important risk factor for many neurological diseases, influencing their development, course, and prognosis. A growing body of evidence highlights the critical role of sleep in brain homeostasis, particularly in removing neurotoxic metabolites through the glymphatic system. This review analyzes the pathophysiological mechanisms linking sleep disorders to selected neurological conditions, including migraine, cognitive decline, and stroke. Objectives. This review aims to examine how sleep disturbances contribute to neurological diseases, including their effects on cognitive function, neuroinflammation, and neuronal health, and to evaluate potential therapeutic strategies for mitigating their impact. Materials and methods. We conducted a comprehensive review of literature through a comprehensive analysis of recent scientific literature sourced from databases such as PubMed, Scopus, and Web of Science. The search focused on studies published between 2010 and 2024 that examined the relationship between sleep disorders and neurological diseases, including migraine, cognitive decline, stroke, Alzheimer’s disease, and Parkinson’s disease. Only peer-reviewed original research, systematic reviews, and meta-analyses written in English, and involving human participants or relevant animal models, were considered. Conclusions. Sleep disorders play a crucial role in the pathogenesis of neurological diseases. Early identification and treatment of these disorders can slow neurodegeneration and improve outcomes. Incorporating sleep assessments into neurological care and utilizing sleep-focused interventions may offer therapeutic and preventive benefits. Further research is needed to identify biomarkers and optimize treatment strategies for long-term impact on disease progression.