Title : Systematic review on the role of the glymphatic system in sleep-related disorders
Abstract:
Objective:
The aim of the study is to assess the implication of dysfunction in the glymphatic system in patients suffering from sleep-related disorders. The secondary aim is to understand the association between the glymphatic system and cognitive decline in patients with sleep-related disorder
Method:
For the systematic review, our screening was narrowed to seven publications. Databases that used included PubMed & Cochrane Library from January 2013- December 2022 and were searched for studies using the keywords “glymphatic system and narcolepsy”, “glymphatic system & sleep disorder”, “glymphatic system & OSA”, “glymphatic system & REM sleep behaviour disorder” “glymphatic system and neurological disorder”, “glymphatic system and sleep”. Our inclusion criteria included- human subjects, time range of publications within 10 years, adults over 18 years, primarily diagnosed with sleep-related disorders, and no secondary causes of sleep-related disorder.
Results:
Based on our study, we found an association between the glymphatic system and sleep-related disorders. In particular, our focus was on REM sleep behaviour disorder (RSBD), narcolepsy, and OSA. It was found that the glymphatic system was impaired in RSBD, narcolepsy, and OSA. In fact, the degree of glymphatic system dysfunction is positively correlated with the severity of the above-mentioned disorder/disease states. Moreover, normal glymphatic flow is increased during the sleep state, our study further suggests that alteration in sleep patterns in these states leads to a decrease in clearance and building-up of brain metabolic waste and amyloid plaques leading to further poor drainage which in turn leads to cognitive impairment.
Conclusion:
This systematic review provides evidence to suggest that dysfunction of the glymphatic system plays a role in the progression of sleep-related disorders of narcolepsy, RSBD, and OSA, which in turn, may lead to cognitive disturbances.
Keywords: RSBD- REM sleep behaviour disorder, OSA- Obstructive sleep apnea
