Study Finds Distinct Brain Changes in Sleep Disorders vs Sleep Deprivation

New research observed distinct convergent brain abnormalities in long-term sleep disorders and short-term sleep deprivation.1

“We observed unique brain alterations across sleep disorders (bilateral sgACC and right amygdala and hippocampus) and sleep deprivation (right thalamus),” wrote investigators, led by Gerion M. Reimann, MSc, from the department of neurology at RWTH Aachen University, in Germany. “Interestingly, the identified convergent alterations were mostly located on the right side of the brain, suggesting an association between sleep disturbance conditions and brain asymmetry.”

Each sleep disorder has its own etiology, and yet many share nocturnal and daytime symptoms, such as sleep duration, sleep fragmentation, daytime sleepiness, and cognitive or mood dysfunctions, suggesting common neurobiological substrates.2

Investigators wanted to know the brain similarities and differences between long-term sleep disorders and short-term sleep deprivation.1 They sought to investigate the shared and specific neural correlates across sleep disorders and sleep deprivation.

Leveraging 140 studies from PubMed, Web of Science, Embase, Scopus, and BrainMap (up to January 2025), the team selected ones reporting on whole-brain neuroimaging and voxel-based group differences between patients with various sleep disorders and healthy controls, as well as between total or partial sleep deprivation and well-rested individuals. In total, the meta-analysis included 3380 participants.

The sleep disorder analysis included 95 studies with 2302 participants, and the sleep deprivation analysis included 45 studies with 1079 participants.

Investigators identified transdiagnostic regional brain alterations across sleep disorders and sleep deprivation. All 95 sleep disorders had consistent brain alterations in 2 regions: bilateral subgenual anterior cingulate cortex and the right amygdala and hippocampus.

The sgACC cluster (176 voxels), linked to reward processing, perception of gustatory stimuli, and reasoning was linked to several sleep disorders, including insomnia (48.7%), obstructive sleep apnea (OSA) (30.5%), narcolepsy (11.5%), OSA and periodic limb movement (5.5%), and rapid eye movement sleep behavior disorder (3.8%). The analysis showed that sgACC related to the bilateral amygdala and hippocampus, posterior cingulate cortex, nucleus accumbens, caudate nucleus, left orbitofrontal cortex, frontal pole, lateral occipital cortex, and precuneus.

The second consistent cluster—the right amygdala and hippocampus (130 voxels) was linked to insomnia (33.8%), OSA (25.3%), narcolepsy (22.2%), restless legs syndrome (6.4%), insomnia and OSA (7.5%), rapid eye movement sleep behavior disorder (2.4%), and congenital central (alveolar) hypoventilation syndrome (2.4%). This cluster was associated with negative emotion processing (anger, anxiety, fear, sadness, and disgust), visual perception, respiratory interception, and memory. The right amygdala and hippocampus were connected to the left amygdala and hippocampus, PCC, nucleus accumbens, caudate nucleus, basal forebrain, fusiform gyrus, medial frontal cortex, Broca region, and left orbitofrontal cortex.

Moreover, 45 sleep deprivation studies showed a cluster inside the right thalamus (153 voxels), located in the ventral-anterior nucleus, dorsal-anterior nucleus, and ventral-posterior nucleus (11.1%). The cluster remained even after 30% noise experiments, suggesting that the thalamus cluster was more stable than the sleep disorder clusters. The thalamus cluster was associated with thermoregulation, pain perception, and action execution.

The analysis showed no overlapping clusters between sleep disorders and sleep deprivation. Findings showed greater convergence in the sgACC and the right amygdala and hippocampus for sleep disorders and more convergence in the right thalamus for sleep deprivation.

“Despite various etiologies, we identified consistent abnormalities in the sgACC and the right amygdala and hippocampus across sleep disorders, probably due to similar nocturnal and daytime symptoms,” investigators concluded.1 “Those regions were associated with emotional and cognitive processes and were connected to the [default mode network]. The right thalamus was consistently identified in short-term sleep deprivation and was associated with distinct behavioral domains and connectivity patterns.”

References

1. Reimann GM, Hoseini A, Koçak M, et al. Distinct Convergent Brain Alterations in Sleep Disorders and Sleep Deprivation: A Meta-Analysis. JAMA Psychiatry. Published online April 23, 2025. doi:10.1001/jamapsychiatry.2025.0488.

2. Freeman D, Sheaves B, Waite F, Harvey AG, Harrison PJ. Sleep disturbance and psychiatric disorders. Lancet Psychiatry. 2020 Jul;7(7):628-637. doi: 10.1016/S2215-0366(20)30136-X. PMID: 32563308.