{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"bioRxiv"}],"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T22:13:07Z","timestamp":1789164787640,"version":"build-2803163510"},"posted":{"date-parts":[[2026,9,8]]},"group-title":"Neuroscience","reference-count":30,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,9,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Hormonal fluctuations during the menstrual cycle (and their suppression) are accompanied by altered mood, cognition, and sleep, yet their relationship to subjective sleep quality and glymphatic function - a sleep- dependent brain waste-clearance pathway that involves perivascular spaces (PVS) - is unclear.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We examined daily oestradiol, progesterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), subjective sleep quality, and MRI-derived PVS volume (PVSV) in a single healthy woman across two 30-day periods: during her physiological menstrual cycle and, one year later, under oral contraceptive pill (OCP) use. We employed linear regression models to examine whether hormones are associated with sleep quality and PVSV, and whether they moderate the sleep quality\u2013PVSV association during the physiological menstrual cycle. Subsequently, we conducted permutation-based Spearman rank correlations to assess whether day-to-day changes in sleep quality were associated with corresponding changes in PVSV across the physiological menstrual cycle and OCP use. False discovery rate (FDR) correction was used to control for multiple comparisons.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Findings<\/jats:title>\n                  <jats:p>\n                    Higher LH levels were associated with poorer sleep quality during the physiological cycle (b=2\u00b715, 95% CI 0\u00b764 to 3\u00b767, p\n                    <jats:sub>FDR<\/jats:sub>\n                    =0\u00b7028), while FSH moderated the sleep quality\u2013PVSV association (b=\u221292\u00b798, 95% CI \u2212160\u00b715 to \u221225\u00b781, p\n                    <jats:sub>FDR<\/jats:sub>\n                    =0\u00b7034), suggesting that lower FSH was associated with lower PVSV, whereas this association reversed at elevated FSH levels characteristic of the periovulatory window. During the physiological menstrual cycle, day-to-day decreases in sleep quality were associated with synchronous increases in PVSV, driven by centrum semiovale PVSV (\u03c1=0\u00b755, 95% CI 0\u00b730 to 0\u00b767, p\n                    <jats:sub>perm<\/jats:sub>\n                    =0\u00b70095). This association was absent during OCP use and differed between hormonal milieus (\u0394\u03c1=0\u00b772, p=0\u00b7040).\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Interpretation<\/jats:title>\n                  <jats:p>Ovulation is characterized by poor sleep quality and reduced PVSV, potentially reflecting noradrenergic modulation. The association between sleep quality and PVSV day-to-day changes is shaped by the hormonal milieu, being absent under OCP. PVSV increase associated with poor sleep may reflect elevated sleep pressure promoting vasomotor-mediated cerebrospinal fluid inflow.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Funding<\/jats:title>\n                  <jats:p>None<\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.09.04.749189","type":"posted-content","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T03:15:21Z","timestamp":1788923721000},"source":"Crossref","is-referenced-by-count":0,"title":["Hormonal Modulation of Subjective Sleep Quality and Perivascular Space Volume Across the Menstrual Cycle: An Observational Dense-Sampling Study"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9290-6058","authenticated-orcid":false,"given":"Daryna","family":"Apter","sequence":"first","affiliation":[{"name":"Institute of Neuroscience and Medicine, Brain and Behaviour (INM\u20137), Research Center J\u00fclich, J\u00fclich, Germany"},{"name":"Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7942-7771","authenticated-orcid":false,"given":"Jorik D.","family":"Elberse","sequence":"additional","affiliation":[{"name":"Institute of Neuroscience and Medicine, Brain and Behaviour (INM\u20137), Research Center J\u00fclich, J\u00fclich, Germany"},{"name":"Institute of Systems Neuroscience, Medical Faculty and University Hospital D\u00fcsseldorf, Heinrich Heine University, D\u00fcsseldorf, Germany"},{"name":"Max Planck School of Cognition, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6601-3336","authenticated-orcid":false,"given":"Laura","family":"Stankeviciute","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, M\u00f6lndal, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7726-6470","authenticated-orcid":false,"given":"Susanne","family":"Weis","sequence":"additional","affiliation":[{"name":"Institute of Neuroscience and Medicine, Brain and Behaviour (INM\u20137), Research Center J\u00fclich, J\u00fclich, Germany"},{"name":"Institute of Systems Neuroscience, Medical Faculty and University Hospital D\u00fcsseldorf, Heinrich Heine University, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6137-416X","authenticated-orcid":false,"given":"David","family":"Elmenhorst","sequence":"additional","affiliation":[{"name":"Institute of Neuroscience and Medicine, Molecular Organization of the Brain (INM-2), Research Center J\u00fclich, J\u00fclich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6910-0080","authenticated-orcid":false,"given":"Jeffrey","family":"Iliff","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA"},{"name":"VA Northwest Mental Illness Research, Education, and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, WA, USA"},{"name":"Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6363-2759","authenticated-orcid":false,"given":"Simon B.","family":"Eickhoff","sequence":"additional","affiliation":[{"name":"Institute of Neuroscience and Medicine, Brain and Behaviour (INM\u20137), Research Center J\u00fclich, J\u00fclich, Germany"},{"name":"Institute of Systems Neuroscience, Medical Faculty and University Hospital D\u00fcsseldorf, Heinrich Heine University, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6187-6987","authenticated-orcid":false,"given":"Carina","family":"Heller","sequence":"additional","affiliation":[{"name":"Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, MN, USA"},{"name":"Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA"},{"name":"Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, USA"},{"name":"German Center for Mental Health (DZPG), Jena\u2013Magdeburg\u2013Halle, Germany"},{"name":"Department of Psychiatry and Psychotherapy, University Hospital Jena, Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3999-3807","authenticated-orcid":false,"given":"Masoud","family":"Tahmasian","sequence":"additional","affiliation":[{"name":"Institute of Neuroscience and Medicine, Brain and Behaviour (INM\u20137), Research Center J\u00fclich, J\u00fclich, Germany"},{"name":"Institute of Systems Neuroscience, Medical Faculty and University Hospital D\u00fcsseldorf, Heinrich Heine University, D\u00fcsseldorf, Germany"},{"name":"Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, 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