SLEEP 2026 | Can enhancing slow-wave sleep improve memory and cognition?

A few words before that on the functions of slow-wave sleep. We know that slow-wave sleep has metabolic effects. It plays a role in metabolic effects, it plays a role in hormonal release, it plays a role in the metabolism of glucose, for example. It also plays a role, an indirect role, in weight regulation. But what really matters to this point is that it also plays a role in cognitive function. That is, slow waves are an indirect reflection of neural circuits going from the hippocampus, very much involved in memory acquisition, and the neocortex, which is a structure of the cortex that is very much involved in memory consolidation. So our short-term memory is transferred during sleep, particularly during slow-wave sleep, from the hippocampus into the neocortex, and the reflection of that are the slow waves. Which means in other words, in the absence of slow-wave sleep, our storage of memory is going to be worse. It is going to be impaired. And if the storage of memory content is being impaired, also our capacity to retrieve memory content is going to be impaired during the dat. Basically, what’s going to happen is that, in the absence of sufficient slow-wave sleep, our cognitive function is likely going to worsen.

So that leads us to the following opportunity. If we improve slow-wave sleep, could that mean that we are able to improve cognitive function in patients? We have been looking at that, and it’s an assumption, that this process could be made backwards, I mean could be changed the other way round. So from impaired slow-wave sleep function, we could go back to improved cognitive function in some patients. There are several ways to improve slow-wave sleep. In general, substances that, for example, substances that increase adenosine are substances that increase also slow-wave sleep. Also substances that are able to reduce glutamate are also substances that should also be able to improve slow-wave sleep, and so it is. What remains to be seen is whether that ultimately leads to an overall improvement in cognitive function. So for example, substances that improve glutamatergic function, are the gabapentinoids. We just talked about them. These substances increase slow-wave sleep. That’s well known. Do gabapentinoids improve memory? A few minutes ago we were talking about dementia, and this is really what remains to be seen because it could be that, over the short term, this increase in slow-wave sleep might effectively lead to an improvement of cognitive function in those patients whose cognitive function was impaired because of slow-wave sleep. However, over the long-term, whether those benefits are maintained over the long term remains to be seen. That’s very speculative at this point. The same thing can be said about adenosinergic drugs. But there are other substances that can be used. For example, a very frequently used substance in this field is sodium oxybate. Sodium oxybate is very frequently being used as an anesthetic, but in the field of sleep medicine it is being used for narcolepsy. It is a drug that reduces cataplexy, and is a drug that also improves daytime wakefulness, and reduces daytime sleepiness. So this drug increases slow-wave sleep heavily, very pronounced, and, to some extent, it also improves cognitive function. Basically, what I’m trying to say is that this is an entire field for which we have very very little data. Studies so far have never been…the number of patients has never aimed to that endpoint. They have never been manned, in terms of number of patients, to answer that question. What was tried until recently was just to see whether slow-wave sleep increased or not. What we still do not know is whether increasing slow-wave sleep effectively leads to an improvement in cognitive function. This is one of the fields of the future, not only in sleep medicine, but also in geriatric medicine and in the field of dementia et cetera.

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