Rest Interrupted: Plasma GFAP, Cerebral Microbleeds, and Sleep Disturbances in Neurodegeneration – Insights from the Southeast Asian BIOCIS Study

This study highlights the dual contributions of neuroinflammatory (i.e., GFAP) and cerebrovascular (i.e., CMBs) in sleep disturbances across cognitive stages. In CU individuals, elevated GFAP likely reflects astrocytic activation disrupting sleep homeostasis. In CI individuals, adaptive astrocytic responses or diminished subjective awareness may explain improved sleep outcomes. CMBs exacerbate specific sleep disturbances in CI individuals, highlighting vascular contributions to sleep regulation. Addressing sleep disturbances could mitigate neurodegeneration, highlighting the need for targeted interventions and public health strategies. Future studies integrating biological sleep assessments is essential to elucidate the interplay between sleep, GFAP, and cerebrovascular pathology.