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The specific contribution of the thalamus to this so\u2010called synaptic renormalization is unknown. Thalamic stroke is associated with daytime sleepiness, along with changes to sleep electroencephalography and cognition, making it a unique \u201cexperiment of nature\u201d to assess the relationship between sleep rhythms, synaptic renormalization, and daytime functions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Sleep was studied by polysomnography and high\u2010density electroencephalography over 17 nights in patients with thalamic (n\u00a0=\u00a012) and 15 nights in patients with extrathalamic (n\u00a0=\u00a011) stroke. Sleep electroencephalographic overnight slow wave slope changes and their relationship with subjective daytime sleepiness, cognition, and other functional tests were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thalamic and extrathalamic patients did not differ in terms of age, sleep duration, or apnea\u2013hypopnea index. Conversely, overnight slope changes were reduced in a large cluster of electrodes in thalamic compared to extrathalamic stroke patients. This reduction was related to increased daytime sleepiness. No significant differences were found in other functional tests between the 2 groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>In patients with thalamic stroke, a reduction in overnight slow wave slope change and increased daytime sleepiness was found. Sleep\u2010 and wake\u2010centered mechanisms for this relationship are discussed. Overall, this study suggests a central role of the thalamus in synaptic renormalization. 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