Sleep Dysfunction in Neurological Disorders: Clinical Significance and Therapeutic Approaches

Introduction:
Sleep disorders are a significant yet underrecognized factor in neurological disease progression and quality of life. Sleep promotes cognitive integrity, facilitates metabolic waste clearance via the glymphatic system, and enhances neuroplasticity. In neurological practice, sleep disturbances are common and clinically significant, affecting disease onset, progression, and patient well-being. The aim of this narrative review is to highlight the role of sleep in neurological diseases and to summarize current therapeutic options for managing sleep disorders in this population.

Literature Review:
Sleep disorders frequently occur in Parkinson’s disease, Alzheimer’s disease, multiple sclerosis, stroke, and Huntington’s disease. Common manifestations include insomnia, restless legs syndrome, obstructive sleep apnea, REM sleep behavior disorder, and excessive daytime sleepiness. Evidence supports the effectiveness of non-pharmacological approaches, such as cognitive-behavioral therapy for insomnia, light therapy, structured physical activity. Pharmacological treatments include melatonin, dopamine agonists, sedative-hypnotics. Novel intervention, including dual orexin receptor antagonists, repetitive transcranial magnetic stimulation, hypoglossal nerve stimulation, and circadian-modulating interventions—are gaining attention in research and clinical practice. Moreover, understanding the underlying pathophysiological mechanisms of sleep disorders in neurology may facilitate the development of more personalized treatment strategies. Including sleep assessment in standard neurological diagnostics may improve early detection and therapeutic outcomes. Sleep-related issues should be systematically addressed as part of holistic neurological care.

Conclusions:
Sleep disorders are a major, modifiable component of neurological disorders. Addressing them improves quality of life and may positively influence disease progression through enhanced neuroprotection, immune regulation, and cognitive preservation. Sleep assessment should be standard in neurological care pathways.