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The night shift: norepinephrine drives glymphatics

Benjamin A. Plog^1,2,* , Leon C. D. Smyth^1,3 , Jonathan Kipnis^1,3,*

¹Brain Immunology and Glia (BIG) Center, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
²Department of Neurosurgery, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
³Department of Pathology and Immunology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
* Correspondence: Benjamin A. Plog(bplog@wustl.edu)Jonathan Kipnis(kipnis@wustl.edu)

The glymphatic system clears waste most efficiently during non-rapid eye movement sleep, driven by rhythmic norepinephrine oscillations that regulate slow vasomotion. This discovery sheds light on the interplay between disruptions in sleep architecture and neurodegenerative diseases and highlights the need for therapies that preserve or restore physiologic sleep patterns to enhance brain clearance.

https://doi.org/10.1038/s41422-025-01106-7

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