Journal
SLEEP MEDICINE REVIEWS
Volume 31, Issue -, Pages 102-111Publisher
W B SAUNDERS CO LTD
DOI: 10.1016/j.smrv.2016.02.002
Keywords
Aging; Amyloid beta; Blood brain barrier; Circadian misalignment; Neurodegeneration; Orexin; Oxidative stress; Sleep disruption; Slow-wave sleep; Tau
Categories
Funding
- Swedish Brain Foundation
- Fredrik and Ingrid Thuring Foundation
- Novo Nordisk Foundation (Denmark)
- AFA Insurance (Sweden)
- Swedish Society for Medical Research
- Swedish Research Council
- National Institute of Health (NIH) [R01HL118624, R21AG049348]
- American Sleep Medicine Foundation
- Leon Levy Foundation
- Novo Nordisk Fonden [NNF14OC0009349] Funding Source: researchfish
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During wakefulness, extracellular levels of metabolites in the brain increase. These include amyloid beta (AO), which contributes to the pathogenesis of Alzheimer's disease (AD). Counterbalancing their accumulation in the brain, sleep facilitates the removal of these metabolites from the extracellular space by convective flow of the interstitial fluid from the para-arterial to the para-venous space. However, when the sleep-wake cycle is disrupted (characterized by increased brain levels of the wake-promoting neuropeptide orexin and increased neural activity), the central nervous system (CNS) clearance of extra cellular metabolites is diminished. Disruptions to the sleep-wake cycle have furthermore been linked to increased neuronal oxidative stress and impaired blood brain barrier function conditions that have also been proposed to play a role in the development and progression of AD. Notably, recent human and transgenic animal studies have demonstrated that AD-related pathophysiological processes that occur long before the clinical onset of AD, such as AO deposition in the brain, disrupt sleep and circadian rhythms. Collectively, as proposed in this review, these findings suggest the existence of a mechanistic interplay between AD pathogenesis and disrupted sleep-wake cycles, which is able to accelerate the development and progression of this disease. (C) 2016 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license.
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