Tang Ying-Lan, Chen Hao-Bo, Liu Peng, Liao Yan-Hui, Xie An
Department of Radiology, The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People's Hospital), Changsha, Hunan, People's Republic of China.
Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China.
Nat Sci Sleep. 2025 Jun 17;17:1377-1390. doi: 10.2147/NSS.S522745. eCollection 2025.
Coronavirus disease-2019 (COVID-19) has led to widespread sleep disturbances, yet the link between post-COVID sleep problems and glymphatic-system function remains unclear.
Between January and March 2023, we enrolled 59 participants with newly developed sleep disorder after COVID-19 (COVID_SD; 24 males; median age 28 years) and 39 age-/sex-matched participants without such problems after COVID-19(COVID_NSD; 15 males; median age 25 y). Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI; 0-21, higher = poorer). All volunteers underwent brain magnetic-resonance imaging (MRI), including diffusion-tensor imaging (DTI), and computation of the DTI analysis along the perivascular space (DTI-ALPS) index. At two-month follow-up, 41 COVID_SD and 25 COVID_NSD participants were rescanned.
Baseline bilateral ALPS indices were lower in COVID_SD than in COVID_NSD (left 1.23 ± 0.08 vs 1.29 ± 0.11, p = 0.033; right 1.29 ± 0.08 vs 1.33 ± 0.11, p = 0.013). PSQI correlated negatively with ALPS (left r = -0.636, p = 0.0002; right r = -0.539, p < 0.0001). Over two months, ALPS increased and PSQI decreased, indicating partial recovery of glymphatic function alongside improved sleep.
Impaired glymphatic clearance is strongly associated with poorer sleep quality in participants with post-COVID sleep problems; improvement in sleep parallels restoration of DTI-ALPS indices.
2019冠状病毒病（COVID-19）已导致广泛的睡眠障碍，但COVID-19后睡眠问题与脑淋巴系统功能之间的联系仍不清楚。
在2023年1月至3月期间，我们招募了59名COVID-19后新出现睡眠障碍的参与者（COVID_SD；24名男性；中位年龄28岁）和39名年龄及性别匹配的COVID-19后无此类问题的参与者（COVID_NSD；15名男性；中位年龄25岁）。使用匹兹堡睡眠质量指数（PSQI；0-21，分数越高睡眠质量越差）评估睡眠质量。所有志愿者均接受了脑磁共振成像（MRI）检查，包括扩散张量成像（DTI），并计算沿血管周围间隙的DTI分析（DTI-ALPS）指数。在两个月的随访中，对41名COVID_SD参与者和25名COVID_NSD参与者进行了再次扫描。
COVID_SD组的基线双侧ALPS指数低于COVID_NSD组（左侧1.23±0.08 vs 1.29±0.11，p = 0.033；右侧1.29±0.08 vs 1.33±0.11，p = 0.013）。PSQI与ALPS呈负相关（左侧r = -0.636，p = 0.0002；右侧r = -0.539，p < 0.0001）。在两个月的时间里，ALPS升高而PSQI降低，表明脑淋巴功能部分恢复，同时睡眠得到改善。
脑淋巴清除功能受损与COVID-19后睡眠问题参与者较差的睡眠质量密切相关；睡眠改善与DTI-ALPS指数的恢复平行。
