AUTHOR=Gaggi Naomi L. , Parincu Zamfira , Peterson Anna , O’Brien Courtney , Kam Korey , Tural Umit , Ayappa Indu , Varga Andrew W. , Iosifescu Dan V. , Osorio Ricardo S. TITLE=Enhancing sleep, wakefulness, and cognition with transcranial photobiomodulation: a systematic review JOURNAL=Frontiers in Behavioral Neuroscience VOLUME=Volume 19 - 2025 YEAR=2025 URL=https://www.frontiersin.org/journals/behavioral-neuroscience/articles/10.3389/fnbeh.2025.1542462 DOI=10.3389/fnbeh.2025.1542462 ISSN=1662-5153 ABSTRACT=Disruptions in sleep are common across clinical populations, particularly those with neurological and psychiatric disorders, making restorative sleep and sustained wakefulness a public health priority. Sleep is essential for brain function, impacting cognition in addition to serving as a critical factor in memory consolidation and healthy aging. Neuromodulation via transcranial photobiomodulation (t-PBM) increases cerebral mitochondrial activity and blood flow. These effects may underlie improvements in sleep quality and wakefulness observed after t-PBM. In this systematic review, we summarize the current literature across clinical and healthy populations, which describes t-PBM’s potential to improve sleep, wakefulness, and cognition. The scope of this review also includes t-PBM’s effect on the brain’s glymphatic system and blood flow, the potential of this strategy to augment alertness, wakefulness, and associated cognitive processes, and the suggestion for targeted t-PBM application for future research based on the underlying neurobiological mechanisms of t-PBM and wakefulness across diverse clinical populations.