Neuromodulation of the Sleeping Brain: From Network Physiology to Clinical Applications

Sleep arises from the complex coordination of large-scale brain networks and homeostatic regulatory systems. However, understanding the causal mechanisms that drive the transition from healthy sleep to pathological states remains a major challenge. This Research Topic aims to bridge basic neuroscience and clinical sleep medicine by exploring neuromodulation both as an investigative tool and as a therapeutic approach.Sleep should be considered a window into neurological health. Subtle alterations in sleep architecture often emerge as early biomarkers of neurodegenerative conditions, such as Alzheimer’s disease and REM sleep behavior disorder, in which network dysfunction precedes overt clinical symptoms. Sleep disturbances are also common in psychiatric disorders and, in some cases, such as drug-resistant bipolar depression, sleep deprivation may transiently relieve symptoms by interfering with altered synaptic plasticity dynamics. At the biological level, these questions converge on synaptic homeostasis and network connectivity. In the healthy brain, the coordinated interaction between slow oscillations and spindles supports essential maintenance processes, including memory consolidation and cerebrospinal fluid-mediated metabolic clearance.When these regulatory networks fail, they may give rise to a broad spectrum of disorders, ranging from chronic insomnia to parasomnias. Characterizing these dysfunctions is essential for the development of circuit-targeted therapeutic strategies. Neuromodulation offers a dual advantage in this context: it can be used both to probe dysfunctional brain states and to restore more physiological sleep patterns. In particular, we are interested in integrated TMS-EEG approaches applied during wakefulness to identify endophenotypes of cortical excitability and effective connectivity associated with different sleep pathologies. Such measures may prove valuable for patient stratification and for predicting individual responses to treatment.From a methodological perspective, this Research Topic welcomes contributions using a wide range of stimulation techniques. In addition to established transcranial magnetic and electrical stimulation approaches, including TMS, tDCS, and tACS, we encourage submissions employing emerging technologies such as Temporal Interference and Transcranial Ultrasound Stimulation. We are especially interested in studies that advance closed-loop systems and home-based platforms capable of real-time brain-state monitoring and personalized stimulation delivery.Overall, this collection seeks to establish a rigorous mechanistic and translational framework for the use of neuromodulation in sleep research and sleep medicine. Topics of interest include, but are not limited to: • neuromodulatory control of sleep rhythms and architecture• slow oscillation-spindle coupling and its role in plasticity, memory, and metabolic clearance• TMS-EEG markers of cortical excitability and effective connectivity in sleep disorders• sleep dysfunction as an early biomarker of neurodegenerative and psychiatric disease• circuit-level mechanisms underlying insomnia, parasomnias, hypersomnias, and REM sleep behavior disorder• therapeutic applications of TMS, tDCS, tACS, Temporal Interference, and Transcranial Ultrasound Stimulation• closed-loop and adaptive stimulation paradigms• wearable and home-based neuromodulation systems• patient phenotyping and prediction of treatment response• translational studies connecting network physiology with clinical interventionTopic Editor Okeanis Vaou is part of the Advisory Board for Medtronic, Abbvie and Amneal. Topic Editor Silvia Casarotto is an advisor and share-holder of Intrinsic Powers, a spin-off of the University of Milan. Topic editors: Okeanis Vaou, Angelica Quercia, Silvia Casarotto Source: https://www.frontiersin.org/research-topics/78350/neuromodulation-of-the-sleeping-brain-from-network-physiology-to-clinical-applications