Mechanisms linking circadian clocks, sleep, and neurodegeneration
Open accessAbstract
Disruptions of normal circadian rhythms and sleep cycles are consequences of aging and can profoundly affect health. Accumulating evidence indicates that circadian and sleep disturbances, which have long been considered symptoms of many neurodegenerative conditions, may actually drive pathogenesis early in the course of these diseases. In this Review, we explore potential cellular and molecular mechanisms linking circadian dysfunction and sleep loss to neurodegenerative diseases, with a focus on Alzheimer’s disease. We examine the interplay between central and peripheral circadian rhythms, circadian clock gene function, and sleep in maintaining brain homeostasis, and discuss therapeutic implications. The circadian clock and sleep can influence a number of key processes involved in neurodegeneration, suggesting that these systems might be manipulated to promote healthy brain aging.
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Circadian rhythm disruption, often from irregular sleep-wake cycles, impairs glymphatic clearance of neurotoxic metabolites like amyloid-beta, exacerbating cognitive decline.
“Circadian rhythm disruption, often resulting from irregular sleep-wake cycles, impairs glymphatic clearance of neurotoxic metabolites like amyloid-β, exacerbating cognitive decline [5].”
From What Are the Key Biological Pathways Through Which Lifestyle Factors Influence Neurodegeneration? (2025) · cites this paper as [5]
In “Sleep and Neurodegeneration” (page not specified), the review reports that slow-wave sleep increases glymphatic clearance of Aβ in mice and that sleep disturbances can affect cognition. But it explicitly says the effect of chronic sleep disturbances on glymphatic function remains uncertain; it does not establish that circadian disruption impairs that clearance and thereby exacerbates cognitive decline. (LLM, conf=0.87)
Experimental — accuracy not yet measuredThe survey finding that diet type and sleep duration were associated with belief in preventability aligns with biological evidence on diet and circadian regulation in modulating neuroinflammation and glymphatic clearance.
“This aligns with biological evidence highlighting the roles of diet and circadian regulation in modulating neuroinflammation and glymphatic clearance [4,5].”
From What Are the Key Biological Pathways Through Which Lifestyle Factors Influence Neurodegeneration? (2025) · cites this paper as [5]
The Inflammation section links circadian clocks to inflammatory responses, and Sleep and Neurodegeneration reports that slow-wave sleep increased glymphatic flow and amyloid-beta clearance in mice. The paper does not establish that diet type modulates neuroinflammation or glymphatic clearance; its discussion of feeding rhythms does not support that part of the claim. No page numbers are available in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredDiffusion MRI indicates age-related changes in white matter connectivity between prefrontal and posterior cortical regions and within posterior sensory cortices.
“Diffusion MRI methods have shown age-related changes in white matter connectivity between prefrontal and posterior cortical regions, and within posterior sensory cortices.25–27”
From Maintenance, reserve and compensation: the cognitive neuroscience of healthy ageing (2018) · cites this paper as [25]
The Sleep and Neurodegeneration section discusses sleep, synaptic function, and medial prefrontal amyloid pathology, while the Circadian function and neurodegeneration section discusses age-related circadian changes. Neither addresses diffusion MRI or the specified age-related white matter connectivity changes. Searches for diffusion MRI and for connectivity in posterior sensory cortices found no supporting passage in our copy; page numbers were unavailable. (LLM, conf=0.76)
Experimental — accuracy not yet measuredAcute administration of ibuprofen led to a delay of SWS in addition to its sleep-disrupting effect.
“Acute administration of ibuprofen, in addition to its sleep disrupting effect, also led to a delay of SWS (398).”
From The Sleep-Immune Crosstalk in Health and Disease (2019) · cites this paper as [398]
Acute administration of aspirin at the recommended daily dose range in healthy participants disrupted sleep (decreased sleep efficiency, increased number of awakenings) and decreased SWS.
“acute administration of aspirin at the recommended daily dose range in healthy participants disrupted sleep (i.e., decreased sleep efficiency, increased number of awakenings) (398) and decreased SWS (241).”
From The Sleep-Immune Crosstalk in Health and Disease (2019) · cites this paper as [398]
There is accumulating evidence linking disrupted sleep and circadian rhythms to neurodegenerative disorders in humans and animal models.
“There is also accumulating evidence linking disrupted sleep and circadian rhythms to neurodegenerative disorders in humans and animal models235,236.”
From Rhythms of life: circadian disruption and brain disorders across the lifespan (2019) · cites this paper as [236]
Older people (ages ~65 years and older) generally sleep less and have poorer sleep efficiency, increased night-time awakening, increased sleep latency and greater levels of daytime sleepiness.
“Older people (ages ~65 years and older) generally sleep less and have poorer sleep efficiency, increased night-time awakening, increased sleep latency and greater levels of daytime sleepiness234–236.”
From Rhythms of life: circadian disruption and brain disorders across the lifespan (2019) · cites this paper as [236]
The build-up and expulsion of reactive oxygen species follow a circadian pattern.
“The build-up and expulsion of reactive oxygen species (ROS) also follow a circadian pattern.”
From Rhythms of life: circadian disruption and brain disorders across the lifespan (2019) · cites this paper as [236]
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“Sleep disruption and risk of amyloid pathology As recounted above and elsewhere (Holth et al., 2017; Ju et al., 2014; Musiek and Holtzman, 2016; Musiek et al., 2015), neurodegenerative disease results in the loss of restorative sleep, which might in turn accentuate the pathological processes that contribute to AD.”
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- Authors
- Musiek, E. S., & Holtzman, D. M.
- Affiliations
- Washington University in St. Louis (US)
- Corresponding author
- Musiek, Erik S.
- Venue
- Science
- Published
- 2016-11-25
- Volume
- 354
- Issue
- 6315
- Pages
- 1004-1008
- ISSN
- 0036-8075 (ISSN-L)
- 1095-9203
- PMC
- PMC5219881
- OpenAlex
- W2553026365
- Cited by
- 878
- References
- 97
- Citations by year
- 2026: 121 · 2025: 135 · 2024: 106 · 2023: 93 · 2022: 87 · 2021: 87 · 2020: 79 · 2019: 63 · 2018: 65 · 2017: 42
- FWCI
- 6.04
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Science (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Neurological Disorders and Stroke (K08NS079405, P01NS074969)
- Topics
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Keywords
- circadian rhythm, sleep, neurodegeneration, Alzheimer's disease, clock genes, sleep deprivation, brain homeostasis, aging, circadian rhythm disruption, therapeutic target
- MeSH terms
- Aging, Alzheimer Disease, Animals, Brain, Circadian Rhythm, Humans, Sleep, Suprachiasmatic Nucleus, Dyssomnias, Mice, Circadian Clocks
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