Sleep as a thermobiological state transition
Keywords:
Sleep, Thermoregulation, NREM sleep, REM sleep, DisabilityAbstract
Sleep has long been framed as the interaction between circadian timing and homeostatic pressure, reflecting a fundamental biological need for survival, neural restoration, and functional integrity. Emerging evidence, however, challenges this binary model and positions thermoregulation as a central organizing principle of sleep biology. This review reconceptualizes sleep as a thermobiological phase transition, in which coordinated changes in brain and body temperature actively initiate, structure, and regulate sleep rather than passively accompany it.
Across species, entry into non-rapid eye movement sleep involves an active reduction in core and cortical temperature mediated by preoptic hypothalamic circuits that integrate peripheral thermal signals with central sleep-promoting networks. Behavioral adaptations, such as peripheral warming and microenvironment optimization, further facilitate these transitions, highlighting the organism’s active role in meeting its sleep need. At the molecular level, temperature-dependent processes link sleep-associated cooling to synaptic maintenance, circadian gene expression, and neuroprotection.
In contrast, rapid eye movement sleep is constrained by thermal permissiveness and reflects efficient energy allocation under favorable conditions. Disruption of sleep–thermoregulatory integration has direct functional consequences and is increasingly recognized as a contributor to disability, particularly in neurological disorders such as synucleinopathies, where impaired temperature regulation coexists with sleep fragmentation and early disease markers. This bidirectional disruption exacerbates cognitive, motor, and autonomic dysfunction, reducing quality of life and functional independence.
Recognizing temperature as a core determinant of sleep not only advances mechanistic understanding but also identifies modifiable pathways to mitigate disability and improve patient outcomes.
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