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REVIEW article

Front. Psychiatry

Sec. Sleep Disorders

Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1545206

This article is part of the Research TopicBrain stimulation for cognitive impairments in psychiatric and neurodegenerative disordersView all 8 articles

Impact of neuromodulation on excessive daytime sleepiness: A narrative review

Provisionally accepted
  • Suzhou Psychiatric Hospital, Suzhou, Jiangsu Province, China

The final, formatted version of the article will be published soon.

Excessive daytime sleepiness (EDS), a global health issue, impairs daily functioning and increases the risk of accidents. Neuromodulation, which can adjust cortical excitability, has emerged as a promising EDS treatment. Although only a few studies have been conducted on this topic and sample sizes were consistently small, the available literature shows that anodal transcranial direct current stimulation or high frequency transcranial alternating current stimulation has been shown to reduce EDS caused by a variety of disorders. Moreover, high frequency repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex or low frequency rTMS targeting the right dorsolateral prefrontal cortex or posterior parietal cortex has demonstrated significant positive effects in the treatment of daytime sleepiness. Moreover, non-invasive neuromodulation has been found to provoke a net gain of cortical arousal, which is linked to the modulation of cortical activity by reducing slow-frequency (δ and θ) activity while enhancing faster frequencies (β1 and β2). Invasive neuromodulation, such as deep brain stimulation, has positive effects on sleep regulation in Parkinson's disease patients, which may contribute to an improvement in EDS. Similarly, vagus nerve stimulation has demonstrated potential benefits for patients with epilepsy, especially those experiencing EDS or co-morbid narcolepsy. Noninvasive neuromodulation for the treatment of EDS presents a promising horizon of opportunities to enhance current therapeutic modalities. However, further research is warranted to refine treatment protocols and validate outcomes through objective measures.

Keywords: excessive daytime sleepiness, Noninvasive neuromodulation, Invasive neuromodulation, Cortical arousal, Top-down pathway

Received: 14 Dec 2024; Accepted: 03 Oct 2025.

Copyright: © 2025 Li, Feng, Pan, Zhang, Du and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Zhe Li, hilizhe@hotmail.com

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