A Review of Cerebral Perfusion Abnormalities in Insomnia and Obstructive Sleep Apnea Based on Brain Imaging Studies
10.14401/KASMED.2025.32.1.1
- Author:
Yoonji JOO
1
;
Hyeonji LEE
;
Youngeun SHIM
;
Sujung YOON
Author Information
1. Ewha Brain Institute, Ewha Women University, Seoul, Korea
- Publication Type:Review
- From:Sleep Medicine and Psychophysiology
2025;32(1):1-14
- CountryRepublic of Korea
- Language:English
-
Abstract:
Sleep disorders represent multifaceted pathophysiological conditions beyond simple sleep duration or quality disruptions. They are frequently associated with neuropsychiatric symptoms, cognitive decline, and systemic health deterioration. Among them, insomnia and obstructive sleep apnea (OSA) are highly prevalent and chronic, with established links to reduced quality of life and an increased risk of neurodegenerative diseases. This review summarized recent findings from neuroimaging studies that used quantitative cerebral blood flow (CBF) techniques, including arterial spin labeling (ASL) and single-photon emission computed tomography (SPECT), to examine functional brain changes associated with these disorders. Both insomnia and OSA consistently showed perfusion abnormalities in regions such as the prefrontal cortex, cingulate cortex, and hippocampus—areas that are critical for the sleep-arousal cycle, emotional regulation, and cognitive control. These alterations may reflect underlying mechanisms that include hemodynamic dysregulation, impaired metabolic regulation, and reduced connectivity in large-scale brain networks.Collectively, the evidence suggested that sleep disorders should be understood not merely as disturbances of sleep architecture, but as conditions involving cerebral hemodynamic dysregulation. Brain perfusion metrics thus hold clinical promise as sensitive biomarkers for early diagnosis, risk stratification, and treatment monitoring in sleep disorders and support the development of precision-guided interventions based on quantitative neuroimaging.
