{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T20:31:18Z","timestamp":1788294678540,"version":"build-2803163510"},"reference-count":89,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Medical Applications Basic Research Project of Suzhou Science and Technology Bureau projects","award":["SKY2023033"],"award-info":[{"award-number":["SKY2023033"]}]},{"name":"Youth Project of Suzhou Science and Education Program for Health","award":["QNXM2025087"],"award-info":[{"award-number":["QNXM2025087"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Study Objectives<\/jats:title>\n                    <jats:p>Whether cerebrospinal fluid (CSF)\u2013dynamics\u2013related glymphatic alterations occur in middle-aged and older adults with chronic insomnia (CI) remains unknown. We therefore examined global and network-level blood oxygenation level\u2013dependent (BOLD)\u2013CSF coupling in this population and assessed the effects of low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) during standardized hypnotic tapering.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This two-stage study included a cross-sectional comparison and a randomized, double-blind, parallel-group, sham-controlled trial. In Stage 1, 43 CI patients and 40 matched healthy controls completed sleep assessments and resting-state functional magnetic resonance imaging to quantify global and network-level BOLD\u2013CSF coupling. In Stage 2, 26 CI patients were randomized (1:1) to receive 4\u00a0weeks of active or sham LF-rTMS during hypnotic tapering. Sleep was assessed at baseline, 2\u00a0weeks, 4\u00a0weeks, and 12\u00a0months. Neuroimaging was acquired at baseline and 4\u00a0weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>CI patients showed significantly reduced global BOLD\u2013CSF coupling, particularly in frontoparietal network (FPN) and default mode network (DMN). Global and FPN coupling correlated with sleep quality. In the randomized trial, LF-rTMS produced greater improvements in sleep at 4\u00a0weeks than sham resulted in fewer participants resuming hypnotics at 12\u00a0months. LF-rTMS increased global and DMN BOLD\u2013CSF coupling, and these changes were associated with improvements in sleep.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Middle-aged and older adults with CI exhibit reduced global BOLD\u2013CSF coupling, indicating alterations in CSF dynamics that may relate to glymphatic function. LF-rTMS improved insomnia symptoms and modulated this coupling, indicating therapeutic potential for CI.<\/jats:p>\n                    <jats:p>Trial Registration: ChiCTR2100049455.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/sleep\/zsag016","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T12:44:38Z","timestamp":1770209078000},"source":"Crossref","is-referenced-by-count":2,"title":["Reduced coupling between global brain activity and cerebrospinal fluid flow in middle-aged and older adults with chronic insomnia: enhancement by low-frequency rTMS"],"prefix":"10.1093","volume":"49","author":[{"given":"Qian","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine, Affiliated Jiangsu Shengze Hospital of Nanjing Medical University , Suzhou 215228 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanqing","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Affiliated Jiangsu Shengze Hospital of Nanjing Medical University , Suzhou 215228 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zongqing","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Affiliated Jiangsu Shengze Hospital of Nanjing Medical University , Suzhou 215228 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianwen","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Affiliated Jiangsu Shengze Hospital of Nanjing Medical University , Suzhou 215228 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenbing","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Affiliated Jiangsu Shengze Hospital of Nanjing Medical University , Suzhou 215228 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuan","family":"He","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Affiliated Jiangsu Shengze Hospital of Nanjing Medical University , Suzhou 215228 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,2,4]]},"reference":[{"issue":"2","key":"2026071807461467300_ref1","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1016\/j.jsmc.2022.03.003","article-title":"Epidemiology of insomnia: prevalence, course, risk factors, and public health burden","volume":"17","author":"Morin","year":"2022","journal-title":"Sleep Med Clin"},{"issue":"1","key":"2026071807461467300_ref2","doi-asserted-by":"publisher","first-page":"2289","DOI":"10.1038\/s41467-021-22354-2","article-title":"Association of sleep duration in middle and old age with incidence of dementia","volume":"12","author":"Sabia","year":"2021","journal-title":"Nat Commun"},{"issue":"11","key":"2026071807461467300_ref3","doi-asserted-by":"publisher","first-page":"1127","DOI":"10.3390\/biology10111127","article-title":"Association between sleep, Alzheimer\u2019s, and Parkinson\u2019s disease","volume":"10","author":"Matsumoto","year":"2021","journal-title":"Biology."},{"key":"2026071807461467300_ref4","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1016\/j.jsmc.2022.02.009","article-title":"Neurodegenerative disorders and sleep","volume":"17","author":"Malhotra","year":"2022","journal-title":"Sleep Med Clin"},{"issue":"2","key":"2026071807461467300_ref5","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1097\/YCO.0000000000000921","article-title":"Recent advances in understanding of sleep disorders and disturbances for dementia risk and prevention","volume":"37","author":"Lam","year":"2024","journal-title":"Curr Opin Psychiatry"},{"issue":"1","key":"2026071807461467300_ref6","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1186\/s12974-020-01960-9","article-title":"The effect of insomnia on development of Alzheimer\u2019s disease","volume":"17","author":"Sadeghmousavi","year":"2020","journal-title":"J Neuroinflammation"},{"issue":"3","key":"2026071807461467300_ref7","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1111\/j.1532-5415.2010.03288.x","article-title":"Greater risk of Alzheimer\u2019s disease in older adults with insomnia","volume":"59","author":"Osorio","year":"2011","journal-title":"J Am Geriatr Soc"},{"issue":"1","key":"2026071807461467300_ref8","doi-asserted-by":"publisher","first-page":"83","DOI":"10.3233\/JAD-215324","article-title":"Burden of insomnia and sleep disturbances and the impact of sleep treatments in patients with probable or possible Alzheimer\u2019s disease: a structured literature review","volume":"86","author":"Benca","year":"2022","journal-title":"J Alzheimer's Dis"},{"key":"2026071807461467300_ref9","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1002\/ana.21680","article-title":"Mild cognitive impairment in rapid eye movement sleep behavior disorder and Parkinson\u2019s disease","volume":"66","author":"Gagnon","year":"2009","journal-title":"Ann Neurol"},{"issue":"21","key":"2026071807461467300_ref10","doi-asserted-by":"publisher","first-page":"12928","DOI":"10.3390\/ijms232112928","article-title":"Glymphatic system dysfunction and sleep disturbance may contribute to the pathogenesis and progression of Parkinson\u2019s disease","volume":"23","author":"Scott-Massey","year":"2022","journal-title":"Int J Mol Sci"},{"issue":"4","key":"2026071807461467300_ref11","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1016\/j.sleep.2014.10.018","article-title":"Cross-cultural and comparative epidemiology of insomnia: the diagnostic and statistical manual (DSM), international classification of diseases (ICD) and international classification of sleep disorders (ICSD)","volume":"16","author":"Chung","year":"2015","journal-title":"Sleep Med"},{"issue":"1","key":"2026071807461467300_ref12","doi-asserted-by":"publisher","first-page":"2084","DOI":"10.1038\/s41467-023-37685-5","article-title":"Plasma neurodegeneration biomarker concentrations associate with glymphatic and meningeal lymphatic measures in neurological disorders","volume":"14","author":"Eide","year":"2023","journal-title":"Nat Commun"},{"issue":"147","key":"2026071807461467300_ref13","doi-asserted-by":"publisher","first-page":"147ra111","DOI":"10.1126\/scitranslmed.3003748","article-title":"A paravascular pathway facilitates CSF flow through the brain parenchyma and the clearance of interstitial solutes, including amyloid \u03b2","volume":"4","author":"Iliff","year":"2012","journal-title":"Sci Transl Med"},{"issue":"12","key":"2026071807461467300_ref14","doi-asserted-by":"publisher","first-page":"2583","DOI":"10.1007\/s11064-015-1581-6","article-title":"The glymphatic system: a beginner\u2019s guide","volume":"40","author":"Jessen","year":"2015","journal-title":"Neurochem Res"},{"issue":"8","key":"2026071807461467300_ref15","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1038\/nrneurol.2015.119","article-title":"Clearance systems in the brain-implications for Alzheimer disease","volume":"11","author":"Tarasoff-Conway","year":"2015","journal-title":"Nat Rev Neurol"},{"issue":"1","key":"2026071807461467300_ref16","doi-asserted-by":"publisher","first-page":"4411","DOI":"10.1038\/s41467-020-18115-2","article-title":"Circadian control of brain glymphatic and lymphatic fluid flow","volume":"11","author":"Hablitz","year":"2020","journal-title":"Nat Commun"},{"issue":"11","key":"2026071807461467300_ref17","doi-asserted-by":"publisher","first-page":"868","DOI":"10.3390\/brainsci10110868","article-title":"The sleeping brain: harnessing the power of the glymphatic system through lifestyle choices","volume":"10","author":"Reddy","year":"2020","journal-title":"Brain Sci"},{"key":"2026071807461467300_ref18","doi-asserted-by":"publisher","first-page":"100025","DOI":"10.1016\/j.cccb.2021.100025","article-title":"Aberrant waste disposal in neurodegeneration: why improved sleep could be the solution","volume":"2","author":"Wafford","year":"2021","journal-title":"Cereb Circ-Cogn Behav"},{"issue":"6","key":"2026071807461467300_ref19","doi-asserted-by":"publisher","first-page":"1046","DOI":"10.1038\/s41593-024-01638-y","article-title":"Brain clearance is reduced during sleep and anesthesia","volume":"27","author":"Miao","year":"2024","journal-title":"Nat Neurosci"},{"issue":"4","key":"2026071807461467300_ref20","doi-asserted-by":"publisher","first-page":"731","DOI":"10.1038\/s41593-025-01897-3","article-title":"A curious concept of CNS clearance","volume":"28","author":"Pl\u00e1","year":"2025","journal-title":"Nat Neurosci"},{"key":"2026071807461467300_ref21","doi-asserted-by":"publisher","first-page":"624690","DOI":"10.3389\/fnins.2021.624690","article-title":"Rethinking the conditions and mechanism for glymphatic clearance","volume":"15","author":"Ferris","year":"2021","journal-title":"Front Neurosci"},{"issue":"4","key":"2026071807461467300_ref22","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1016\/j.neuron.2024.12.009","article-title":"Anything but small: microarousals stand at the crossroad between noradrenaline signaling and key sleep functions","volume":"113","author":"L\u00fcthi","year":"2025","journal-title":"Neuron."},{"issue":"6465","key":"2026071807461467300_ref23","doi-asserted-by":"publisher","first-page":"628","DOI":"10.1126\/science.aax5440","article-title":"Coupled electrophysiological, hemodynamic, and cerebrospinal fluid oscillations in human sleep","volume":"366","author":"Fultz","year":"2019","journal-title":"Science."},{"issue":"6","key":"2026071807461467300_ref24","doi-asserted-by":"publisher","first-page":"e13928","DOI":"10.1111\/jsr.13928","article-title":"Hyperarousal in insomnia disorder: current evidence and potential mechanisms","volume":"32","author":"Dressle","year":"2023","journal-title":"J Sleep Res"},{"issue":"1","key":"2026071807461467300_ref25","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1038\/s41467-017-02815-3","article-title":"Subcortical evidence for a contribution of arousal to fMRI studies of brain activity","volume":"9","author":"Liu","year":"2018","journal-title":"Nat Commun"},{"issue":"1","key":"2026071807461467300_ref26","doi-asserted-by":"publisher","first-page":"1214","DOI":"10.1038\/s41467-017-01150-x","article-title":"Earliest accumulation of \u03b2-amyloid occurs within the default-mode network and concurrently affects brain connectivity","volume":"8","author":"Palmqvist","year":"2017","journal-title":"Nat Commun"},{"issue":"1","key":"2026071807461467300_ref27","doi-asserted-by":"publisher","first-page":"7788","DOI":"10.1038\/s41467-023-43627-y","article-title":"Resting-state global brain activity affects early \u03b2-amyloid accumulation in default mode network","volume":"14","author":"Han","year":"2023","journal-title":"Nat Commun"},{"issue":"2","key":"2026071807461467300_ref28","doi-asserted-by":"publisher","first-page":"1114","DOI":"10.21037\/qims-24-1447","article-title":"Evaluation of glymphatic system dysfunction in patients with insomnia via diffusion tensor image analysis along the perivascular space","volume":"15","author":"Xiong","year":"2025","journal-title":"Quant Imaging Med Surg"},{"key":"2026071807461467300_ref29","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/j.sleep.2024.01.028","article-title":"Glymphatic system dysfunction in middle-aged and elderly chronic insomnia patients with cognitive impairment evidenced by diffusion tensor imaging along the perivascular space (DTI-ALPS)","volume":"115","author":"Jin","year":"2024","journal-title":"Sleep Med"},{"key":"2026071807461467300_ref30","doi-asserted-by":"publisher","first-page":"1545885","DOI":"10.3389\/fnins.2025.1545885","article-title":"The change of MRI indexes of brain glymphatic function and sleep status before and after repeated transcranial magnetic stimulation in insomnia disorder patients","volume":"19","author":"Gao","year":"2025","journal-title":"Front Neurosci"},{"key":"2026071807461467300_ref31","doi-asserted-by":"publisher","first-page":"1377","DOI":"10.2147\/NSS.S522745","article-title":"Glymphatic function alterations in sleep disorder patients post-COVID-19: a longitudinal DTI-ALPS study","volume":"17","author":"Tang","year":"2025","journal-title":"Nat Sci Sleep"},{"issue":"6","key":"2026071807461467300_ref32","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsaf083","article-title":"Enhancement of glymphatic function and cognition in chronic insomnia using low-frequency rTMS","volume":"48","author":"Zhang","year":"2025","journal-title":"Sleep."},{"issue":"8","key":"2026071807461467300_ref33","doi-asserted-by":"publisher","first-page":"5446","DOI":"10.1007\/s00330-022-08649-y","article-title":"MRI-visible enlarged perivascular spaces: imaging marker to predict cognitive impairment in older chronic insomnia patients","volume":"32","author":"Wang","year":"2022","journal-title":"Eur Radiol"},{"issue":"6756","key":"2026071807461467300_ref34","doi-asserted-by":"publisher","first-page":"eadv8269","DOI":"10.1126\/science.adv8269","article-title":"Glymphatic dysfunction in Alzheimer\u2019s disease: a critical appraisal","volume":"389","author":"Keil","year":"2025","journal-title":"Science."},{"issue":"6","key":"2026071807461467300_ref35","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.1177\/0271678X221074639","article-title":"Coupling between cerebrovascular oscillations and CSF flow fluctuations during wakefulness: an fMRI study","volume":"42","author":"Yang","year":"2022","journal-title":"J Cereb Blood Flow Metab"},{"issue":"10","key":"2026071807461467300_ref36","doi-asserted-by":"publisher","first-page":"4665","DOI":"10.1038\/s41380-025-03058-1","article-title":"Reduced glymphatic clearance in early psychosis","volume":"30","author":"Hua","year":"2025","journal-title":"Mol Psychiatry"},{"key":"2026071807461467300_ref37","doi-asserted-by":"publisher","first-page":"121097","DOI":"10.1016\/j.neuroimage.2025.121097","article-title":"Test-retest reliability of coupling between cerebrospinal fluid flow and global brain activity after normal sleep and sleep deprivation","volume":"309","author":"Zhao","year":"2025","journal-title":"NeuroImage."},{"issue":"6","key":"2026071807461467300_ref38","doi-asserted-by":"publisher","first-page":"e3001233","DOI":"10.1371\/journal.pbio.3001233","article-title":"Reduced coupling between cerebrospinal fluid flow and global brain activity is linked to Alzheimer disease-related pathology","volume":"19","author":"Han","year":"2021","journal-title":"PLoS Biol"},{"issue":"3","key":"2026071807461467300_ref39","doi-asserted-by":"publisher","first-page":"101322","DOI":"10.1016\/j.neurad.2025.101322","article-title":"Emerging non-invasive MRI techniques for glymphatic system assessment in neurodegenerative disease","volume":"52","author":"Botta","year":"2025","journal-title":"J Neuroradiol"},{"issue":"6","key":"2026071807461467300_ref40","doi-asserted-by":"publisher","first-page":"e14035","DOI":"10.1111\/jsr.14035","article-title":"The European insomnia guideline: an update on the diagnosis and treatment of insomnia 2023","volume":"32","author":"Riemann","year":"2023","journal-title":"J Sleep Res"},{"key":"2026071807461467300_ref41","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1016\/j.sleep.2025.01.033","article-title":"Clinical practice guidelines for switching or deprescribing hypnotic medications for chronic insomnia: results of European neuropsychopharmacology and sleep expert\u2019s consensus group","volume":"128","author":"Palagini","year":"2025","journal-title":"Sleep Med"},{"issue":"6","key":"2026071807461467300_ref42","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1016\/j.sleep.2014.02.004","article-title":"Speed and trajectory of changes of insomnia symptoms during acute treatment with cognitive-behavioral therapy, singly and combined with medication","volume":"15","author":"Morin","year":"2014","journal-title":"Sleep Med"},{"issue":"2","key":"2026071807461467300_ref43","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1007\/s40264-015-0362-0","article-title":"Mortality risk of hypnotics: strengths and limits of evidence","volume":"39","author":"Kripke","year":"2016","journal-title":"Drug Saf"},{"issue":"4","key":"2026071807461467300_ref44","doi-asserted-by":"publisher","first-page":"e14088","DOI":"10.1111\/jsr.14088","article-title":"Comparative short-term safety and efficacy of hypnotics: a quantitative risk-benefit analysis","volume":"33","author":"Cheung","year":"2024","journal-title":"J Sleep Res"},{"key":"2026071807461467300_ref45","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1016\/j.jsmc.2020.02.003","article-title":"Hypnotic discontinuation in chronic insomnia","volume":"15","author":"Hintze","year":"2020","journal-title":"Sleep Med Clin"},{"issue":"7","key":"2026071807461467300_ref46","doi-asserted-by":"publisher","first-page":"2493","DOI":"10.3390\/jcm12072493","article-title":"Alliance for sleep clinical practice guideline on switching or deprescribing hypnotic medications for insomnia","volume":"12","author":"Watson","year":"2023","journal-title":"J Clin Med"},{"key":"2026071807461467300_ref47","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1016\/j.sleep.2020.05.020","article-title":"The effect of repetitive transcranial magnetic stimulation for insomnia: a systematic review and meta-analysis","volume":"77","author":"Sun","year":"2021","journal-title":"Sleep Med"},{"key":"2026071807461467300_ref48","doi-asserted-by":"publisher","first-page":"101735","DOI":"10.1016\/j.smrv.2022.101735","article-title":"Repetitive transcranial magnetic stimulation in primary sleep disorders","volume":"67","author":"Lanza","year":"2023","journal-title":"Sleep Med Rev"},{"issue":"6","key":"2026071807461467300_ref49","doi-asserted-by":"publisher","first-page":"e13979","DOI":"10.1111\/jsr.13979","article-title":"Complementary and alternative treatments for insomnia disorder: a systematic umbrella review","volume":"32","author":"Ell","year":"2023","journal-title":"J Sleep Res"},{"key":"2026071807461467300_ref50","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1016\/j.sleep.2020.01.028","article-title":"Effects of repetitive transcranial magnetic stimulation in subjects with sleep disorders","volume":"71","author":"Nardone","year":"2020","journal-title":"Sleep Med"},{"key":"2026071807461467300_ref51","doi-asserted-by":"publisher","first-page":"107050","DOI":"10.1016\/j.parkreldis.2024.107050","article-title":"Objective sleep enhancement in Parkinson\u2019s disease: a sham-controlled trial of low-frequency repetitive transcranial magnetic stimulation over the right dorsolateral prefrontal cortex","volume":"126","author":"Wu","year":"2024","journal-title":"Parkinsonism Relat Disord"},{"key":"2026071807461467300_ref52","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1016\/j.sleep.2025.03.009","article-title":"Decoupling of global signal and cerebrospinal fluid inflow is associated with cognitive decline in patients with obstructive sleep apnoea","volume":"129","author":"Li","year":"2025","journal-title":"Sleep Med"},{"key":"2026071807461467300_ref53","doi-asserted-by":"publisher","first-page":"103815","DOI":"10.1016\/j.nicl.2025.103815","article-title":"Precision targeting of right dorsolateral prefrontal cortex with neuronavigated rTMS alleviates chronic insomnia via functional connectivity reorganization: a randomized neuroimaging trial","volume":"47","author":"Gong","year":"2025","journal-title":"NeuroImage Clin"},{"issue":"1","key":"2026071807461467300_ref54","doi-asserted-by":"publisher","first-page":"e70119","DOI":"10.1002\/hbm.70119","article-title":"Subtypes of insomnia disorder identified by cortical morphometric similarity network","volume":"46","author":"Zhang","year":"2025","journal-title":"Hum Brain Mapp"},{"issue":"6","key":"2026071807461467300_ref55","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1097\/JCMA.0000000000000924","article-title":"Effect of low-frequency repetitive transcranial magnetic stimulation as adjunctive treatment for insomnia patients under hypnotics: a randomized, double-blind, sham-controlled study","volume":"86","author":"Lin","year":"2023","journal-title":"J Chin Med Assoc"},{"issue":"6","key":"2026071807461467300_ref56","doi-asserted-by":"publisher","first-page":"1071","DOI":"10.1016\/j.clinph.2015.02.001","article-title":"Non-invasive electrical and magnetic stimulation of the brain, spinal cord, roots and peripheral nerves: basic principles and procedures for routine clinical and research application: an updated report from an I.F.C.N. Committee","volume":"126","author":"Rossini","year":"2015","journal-title":"Clin Neurophysiol"},{"key":"2026071807461467300_ref57","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1016\/j.jpsychires.2023.02.005","article-title":"The potential of electroencephalography coherence to predict the outcome of repetitive transcranial magnetic stimulation in insomnia disorder","volume":"160","author":"Zhang","year":"2023","journal-title":"J Psychiatr Res"},{"key":"2026071807461467300_ref58","doi-asserted-by":"publisher","first-page":"410785","DOI":"10.1155\/2015\/410785","article-title":"The role of the right dorsolateral prefrontal cortex in phasic alertness: evidence from a contingent negative variation and repetitive transcranial magnetic stimulation study","volume":"2015","author":"Mannarelli","year":"2015","journal-title":"Neural Plast"},{"issue":"2","key":"2026071807461467300_ref59","doi-asserted-by":"publisher","first-page":"307","DOI":"10.5664\/jcsm.6470","article-title":"Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: an American Academy of Sleep Medicine clinical practice guideline","volume":"13","author":"Sateia","year":"2017","journal-title":"J Clin Sleep Med"},{"key":"2026071807461467300_ref60","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1037\/\/0022-006x.56.6.893","article-title":"An inventory for measuring clinical anxiety: psychometric properties","volume":"56","author":"Beck","year":"1988","journal-title":"J Consult Clin Psychol"},{"issue":"9","key":"2026071807461467300_ref61","doi-asserted-by":"publisher","first-page":"E2105","DOI":"10.1073\/pnas.1720985115","article-title":"Ridding fMRI data of motion-related influences: removal of signals with distinct spatial and physical bases in multiecho data","volume":"115","author":"Power","year":"2018","journal-title":"Proc Natl Acad Sci U S A"},{"key":"2026071807461467300_ref62","doi-asserted-by":"publisher","first-page":"116614","DOI":"10.1016\/j.neuroimage.2020.116614","article-title":"Identifying and removing widespread signal deflections from fMRI data: rethinking the global signal regression problem","volume":"212","author":"Aquino","year":"2020","journal-title":"NeuroImage."},{"issue":"3","key":"2026071807461467300_ref63","doi-asserted-by":"publisher","first-page":"968","DOI":"10.1016\/j.neuroimage.2006.01.021","article-title":"An automated labeling system for subdividing the human cerebral cortex on MRI scans into gyral based regions of interest","volume":"31","author":"Desikan","year":"2006","journal-title":"NeuroImage."},{"issue":"10","key":"2026071807461467300_ref64","doi-asserted-by":"publisher","first-page":"2487","DOI":"10.1185\/03007990903167415","article-title":"Interpreting score differences in the insomnia severity index: using health-related outcomes to define the minimally important difference","volume":"25","author":"Yang","year":"2009","journal-title":"Curr Med Res Opin"},{"key":"2026071807461467300_ref65","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1016\/j.jad.2024.03.023","article-title":"Reduced coupling between global signal and cerebrospinal fluid inflow in patients with depressive disorder: a resting state functional MRI study","volume":"354","author":"Zhang","year":"2024","journal-title":"J Affect Disord"},{"key":"2026071807461467300_ref66","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1177\/1358836X9000100202","article-title":"Vasomotion and flowmotion: physiological mechanisms and clinical evidence","volume":"vmr\u20131","author":"Intaglietta","year":"1990","journal-title":"Vasc Med Rev"},{"issue":"2","key":"2026071807461467300_ref67","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1111\/j.1748-1716.2010.02198.x","article-title":"Informational dynamics of vasomotion in microvascular networks: a review","volume":"201","author":"Pradhan","year":"2011","journal-title":"Acta Physiol"},{"issue":"1","key":"2026071807461467300_ref68","doi-asserted-by":"publisher","first-page":"9491","DOI":"10.1038\/s41598-025-94212-w","article-title":"Sleep deprivation impairs neurovascular coupling and cerebral vasomotor reactivity","volume":"15","author":"Rab-B\u00e1bel","year":"2025","journal-title":"Sci Rep"},{"issue":"6","key":"2026071807461467300_ref69","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsy048","article-title":"Assessment of sympathetic neural activity in chronic insomnia: evidence for elevated cardiovascular risk","volume":"41","author":"Carter","year":"2018","journal-title":"Sleep."},{"issue":"1","key":"2026071807461467300_ref70","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/s40478-022-01498-2","article-title":"Sleep fragmentation affects glymphatic system through the different expression of AQP4 in wild type and 5xFAD mouse models","volume":"11","author":"Vasciaveo","year":"2023","journal-title":"Acta Neuropathol Commun"},{"issue":"9","key":"2026071807461467300_ref71","doi-asserted-by":"publisher","first-page":"1515","DOI":"10.1177\/0271678X241230188","article-title":"Chronic sleep fragmentation impairs brain interstitial clearance in young wildtype mice","volume":"44","author":"Deng","year":"2024","journal-title":"J Cereb Blood Flow Metab"},{"issue":"16","key":"2026071807461467300_ref72","doi-asserted-by":"publisher","first-page":"2469","DOI":"10.1016\/j.neuron.2023.04.023","article-title":"20 years of the default mode network: a review and synthesis","volume":"111","author":"Menon","year":"2023","journal-title":"Neuron."},{"issue":"14","key":"2026071807461467300_ref73","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1097\/WNR.0000000000001949","article-title":"Functional connectivity of the default mode network predicts subsequent polysomnographically measured sleep in people with symptoms of insomnia","volume":"34","author":"Killgore","year":"2023","journal-title":"Neuroreport."},{"issue":"6","key":"2026071807461467300_ref74","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1016\/j.tics.2007.04.005","article-title":"An information theoretical approach to prefrontal executive function","volume":"11","author":"Koechlin","year":"2007","journal-title":"Trends Cogn Sci"},{"issue":"1","key":"2026071807461467300_ref75","doi-asserted-by":"publisher","first-page":"5891","DOI":"10.1038\/s41598-018-23699-3","article-title":"Altered connection properties of important network hubs may be neural risk factors for individuals with primary insomnia","volume":"8","author":"Liu","year":"2018","journal-title":"Sci Rep"},{"key":"2026071807461467300_ref76","doi-asserted-by":"publisher","first-page":"1229","DOI":"10.2147\/NDT.S162325","article-title":"Disrupted interhemispheric functional connectivity in chronic insomnia disorder: a resting-state fMRI study","volume":"14","author":"Zhou","year":"2018","journal-title":"Neuropsychiatr Dis Treat"},{"issue":"6","key":"2026071807461467300_ref77","doi-asserted-by":"publisher","first-page":"1355","DOI":"10.1007\/s11682-024-00922-6","article-title":"Insomnia and stress: the mediating roles of frontoparietal network","volume":"18","author":"He","year":"2024","journal-title":"Brain Imaging Behav"},{"issue":"1","key":"2026071807461467300_ref78","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1038\/s41398-019-0560-0","article-title":"Repetitive negative thinking in daily life and functional connectivity among default mode, fronto-parietal, and salience networks","volume":"9","author":"Lydon-Staley","year":"2019","journal-title":"Transl Psychiatry"},{"issue":"2","key":"2026071807461467300_ref79","doi-asserted-by":"publisher","first-page":"664","DOI":"10.1007\/s00330-017-5012-8","article-title":"Altered resting state connectivity in right side frontoparietal network in primary insomnia patients","volume":"28","author":"Li","year":"2018","journal-title":"Eur Radiol"},{"issue":"5","key":"2026071807461467300_ref80","doi-asserted-by":"publisher","first-page":"1608","DOI":"10.1073\/pnas.0807933106","article-title":"Source modeling sleep slow waves","volume":"106","author":"Murphy","year":"2009","journal-title":"Proc Natl Acad Sci U S A"},{"key":"2026071807461467300_ref81","doi-asserted-by":"publisher","first-page":"101878","DOI":"10.1016\/j.smrv.2023.101878","article-title":"Towards the neurobiology of insomnia: a systematic review of neuroimaging studies","volume":"73","author":"Aquino","year":"2024","journal-title":"Sleep Med Rev"},{"issue":"20","key":"2026071807461467300_ref82","doi-asserted-by":"publisher","first-page":"8496","DOI":"10.1073\/pnas.0702495104","article-title":"Triggering sleep slow waves by transcranial magnetic stimulation","volume":"104","author":"Massimini","year":"2007","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"Pt 2","key":"2026071807461467300_ref83","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1113\/jphysiol.2006.108464","article-title":"Effects of repetitive TMS on visually evoked potentials and EEG in the anaesthetized cat: dependence on stimulus frequency and train duration","volume":"574","author":"Aydin-Abidin","year":"2006","journal-title":"J Physiol"},{"issue":"8","key":"2026071807461467300_ref84","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/23.8.1g","article-title":"Conventional and power spectrum analysis of the effects of zolpidem on sleep EEG in patients with chronic primary insomnia","volume":"23","author":"Monti","year":"2000","journal-title":"Sleep."},{"issue":"11","key":"2026071807461467300_ref85","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsaa084","article-title":"The effect of zolpidem on memory consolidation over a night of sleep","volume":"43","author":"Zhang","year":"2020","journal-title":"Sleep."},{"issue":"1","key":"2026071807461467300_ref86","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1186\/s12916-024-03358-3","article-title":"Sleep alterations as a function of 88 health indicators","volume":"22","author":"Ujma","year":"2024","journal-title":"BMC Med"},{"issue":"2","key":"2026071807461467300_ref87","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1007\/s42761-021-00079-1","article-title":"Zolpidem maintains memories for negative emotions across a night of sleep","volume":"3","author":"Simon","year":"2022","journal-title":"Affect Sci"},{"issue":"1","key":"2026071807461467300_ref88","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1186\/s40478-021-01198-3","article-title":"Repetitive transcranial magnetic stimulation increases the brain\u2019s drainage efficiency in a mouse model of Alzheimer\u2019s disease","volume":"9","author":"Lin","year":"2021","journal-title":"Acta Neuropathol Commun"},{"key":"2026071807461467300_ref89","doi-asserted-by":"publisher","first-page":"1135995","DOI":"10.3389\/fnins.2023.1135995","article-title":"Functional connectivity changes are correlated with sleep improvement in chronic insomnia patients after rTMS treatment","volume":"17","author":"Zhu","year":"2023","journal-title":"Front Neurosci"}],"container-title":["SLEEP"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/sleep\/advance-article-pdf\/doi\/10.1093\/sleep\/zsag016\/66747246\/zsag016.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/sleep\/article-pdf\/49\/7\/zsag016\/66747246\/zsag016.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/sleep\/article-pdf\/49\/7\/zsag016\/66747246\/zsag016.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T11:46:19Z","timestamp":1784375179000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/sleep\/article\/doi\/10.1093\/sleep\/zsag016\/8459396"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,4]]},"references-count":89,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,2,4]]},"published-print":{"date-parts":[[2026,7,13]]}},"URL":"https:\/\/doi.org\/10.1093\/sleep\/zsag016","relation":{},"ISSN":["0161-8105","1550-9109"],"issn-type":[{"value":"0161-8105","type":"print"},{"value":"1550-9109","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,7]]},"published":{"date-parts":[[2026,2,4]]},"article-number":"zsag016"}}