Mapping human sleep-state brain function with simultaneous EEG and neuroimaging: A systematic review

Angeliki Pollatou; Grant Tays; Lillian Skeiky; William Coon; Clara Scholl; Nastaren Abad; Elizabeth Metzger; Luca Marinelli; Afis Ajala; Ping Hong Yeh; Tracy Jill Doty; Robert Shih; Angelica Lee; Vincent F. Capaldi; Sharon Kim; J. Kent Werner

doi:10.1016/j.neuroimage.2026.122122

Mapping human sleep-state brain function with simultaneous EEG and neuroimaging: A systematic review

Angeliki Pollatou^*
, Grant Tays
, Lillian Skeiky
, William Coon
, Clara Scholl
, Nastaren Abad
, Elizabeth Metzger
, Luca Marinelli
, Afis Ajala
, Ping Hong Yeh
, Tracy Jill Doty
, Robert Shih
, Angelica Lee
, Vincent F. Capaldi
, Sharon Kim
, J. Kent Werner

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

Abstract

Sleep is a dynamic process involving complex changes in brain activity across distinct stages, yet the neurobiology of these transitions remains poorly understood. Simultaneous electroencephalography (EEG) and neuroimaging provide a unique window into stage-specific brain activity by combining the temporal precision of EEG with the spatial resolution of functional Magnetic Resonance Imaging (fMRI), Positron Emission Tomography (PET), and the signal specificity of Near-Infrared Spectroscopy (NIRS). We conducted the first systematic review of simultaneous EEG-neuroimaging studies of human sleep. Systematic searches across five databases identified 205 eligible studies. Eligible studies recorded simultaneous EEG and fMRI, PET, or NIRS during sleep in humans, with EEG-based staging; sequential acquisition and awake-only studies were excluded. Findings were grouped by imaging modality, sleep state (NREM, REM, transitions), sleep manipulation type, and population (healthy vs. clinical). The majority used EEG-fMRI (n=141), with smaller numbers employing EEG-PET (n=34), EEG-NIRS (n=26), and multimodal combinations (n=4). Despite heterogeneity in protocols and analyses, convergent findings highlight robust thalamic, precuneus and cingulate involvement across non-REM (NREM) stages, with additional modality-specific insights. REM sleep showed increased activity in limbic and paralimbic networks, alongside reduced activity in executive control regions. Studies varied in design (49% overnight-only, 20% nap-only), populations (74% healthy adults only), and staging approaches (61% using 30-sec epochs), with methodological challenges including small sample sizes (median N=18) and heterogeneity in sleep manipulation protocols (28% used sleep restriction). This systematic review synthesizes three decades of simultaneous EEG-neuroimaging, mapping convergent and divergent findings across modalities to advance understanding of sleep-state brain function.

Original language	English
Article number	122122
Journal	NeuroImage
Volume	338
DOIs	https://doi.org/10.1016/j.neuroimage.2026.122122
State	Published - Sep 2026

Keywords

EEG-NIRS
EEG-PET
EEG-fMRI
NREM sleep
REM sleep
Sleep neuroimaging

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10.1016/j.neuroimage.2026.122122

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Pollatou, A., Tays, G., Skeiky, L., Coon, W., Scholl, C., Abad, N., Metzger, E., Marinelli, L., Ajala, A., Yeh, P. H., Doty, T. J., Shih, R., Lee, A., Capaldi, V. F., Kim, S., & Kent Werner, J. (2026). Mapping human sleep-state brain function with simultaneous EEG and neuroimaging: A systematic review. NeuroImage, 338, Article 122122. https://doi.org/10.1016/j.neuroimage.2026.122122

@article{e976aefcf23544a2afbc2964a654fccc,

title = "Mapping human sleep-state brain function with simultaneous EEG and neuroimaging: A systematic review",

abstract = "Sleep is a dynamic process involving complex changes in brain activity across distinct stages, yet the neurobiology of these transitions remains poorly understood. Simultaneous electroencephalography (EEG) and neuroimaging provide a unique window into stage-specific brain activity by combining the temporal precision of EEG with the spatial resolution of functional Magnetic Resonance Imaging (fMRI), Positron Emission Tomography (PET), and the signal specificity of Near-Infrared Spectroscopy (NIRS). We conducted the first systematic review of simultaneous EEG-neuroimaging studies of human sleep. Systematic searches across five databases identified 205 eligible studies. Eligible studies recorded simultaneous EEG and fMRI, PET, or NIRS during sleep in humans, with EEG-based staging; sequential acquisition and awake-only studies were excluded. Findings were grouped by imaging modality, sleep state (NREM, REM, transitions), sleep manipulation type, and population (healthy vs. clinical). The majority used EEG-fMRI (n=141), with smaller numbers employing EEG-PET (n=34), EEG-NIRS (n=26), and multimodal combinations (n=4). Despite heterogeneity in protocols and analyses, convergent findings highlight robust thalamic, precuneus and cingulate involvement across non-REM (NREM) stages, with additional modality-specific insights. REM sleep showed increased activity in limbic and paralimbic networks, alongside reduced activity in executive control regions. Studies varied in design (49\% overnight-only, 20\% nap-only), populations (74\% healthy adults only), and staging approaches (61\% using 30-sec epochs), with methodological challenges including small sample sizes (median N=18) and heterogeneity in sleep manipulation protocols (28\% used sleep restriction). This systematic review synthesizes three decades of simultaneous EEG-neuroimaging, mapping convergent and divergent findings across modalities to advance understanding of sleep-state brain function.",

keywords = "EEG-NIRS, EEG-PET, EEG-fMRI, NREM sleep, REM sleep, Sleep neuroimaging",

author = "Angeliki Pollatou and Grant Tays and Lillian Skeiky and William Coon and Clara Scholl and Nastaren Abad and Elizabeth Metzger and Luca Marinelli and Afis Ajala and Yeh, \{Ping Hong\} and Doty, \{Tracy Jill\} and Robert Shih and Angelica Lee and Capaldi, \{Vincent F.\} and Sharon Kim and \{Kent Werner\}, J.",

note = "Publisher Copyright: {\textcopyright} 2026 The Author(s).",

year = "2026",

month = sep,

doi = "10.1016/j.neuroimage.2026.122122",

language = "English",

volume = "338",

journal = "NeuroImage",

issn = "1053-8119",

publisher = "Academic Press Inc.",

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TY - JOUR

T1 - Mapping human sleep-state brain function with simultaneous EEG and neuroimaging

T2 - A systematic review

AU - Pollatou, Angeliki

AU - Tays, Grant

AU - Skeiky, Lillian

AU - Coon, William

AU - Scholl, Clara

AU - Abad, Nastaren

AU - Metzger, Elizabeth

AU - Marinelli, Luca

AU - Ajala, Afis

AU - Yeh, Ping Hong

AU - Doty, Tracy Jill

AU - Shih, Robert

AU - Lee, Angelica

AU - Capaldi, Vincent F.

AU - Kim, Sharon

AU - Kent Werner, J.

PY - 2026/9

Y1 - 2026/9

N2 - Sleep is a dynamic process involving complex changes in brain activity across distinct stages, yet the neurobiology of these transitions remains poorly understood. Simultaneous electroencephalography (EEG) and neuroimaging provide a unique window into stage-specific brain activity by combining the temporal precision of EEG with the spatial resolution of functional Magnetic Resonance Imaging (fMRI), Positron Emission Tomography (PET), and the signal specificity of Near-Infrared Spectroscopy (NIRS). We conducted the first systematic review of simultaneous EEG-neuroimaging studies of human sleep. Systematic searches across five databases identified 205 eligible studies. Eligible studies recorded simultaneous EEG and fMRI, PET, or NIRS during sleep in humans, with EEG-based staging; sequential acquisition and awake-only studies were excluded. Findings were grouped by imaging modality, sleep state (NREM, REM, transitions), sleep manipulation type, and population (healthy vs. clinical). The majority used EEG-fMRI (n=141), with smaller numbers employing EEG-PET (n=34), EEG-NIRS (n=26), and multimodal combinations (n=4). Despite heterogeneity in protocols and analyses, convergent findings highlight robust thalamic, precuneus and cingulate involvement across non-REM (NREM) stages, with additional modality-specific insights. REM sleep showed increased activity in limbic and paralimbic networks, alongside reduced activity in executive control regions. Studies varied in design (49% overnight-only, 20% nap-only), populations (74% healthy adults only), and staging approaches (61% using 30-sec epochs), with methodological challenges including small sample sizes (median N=18) and heterogeneity in sleep manipulation protocols (28% used sleep restriction). This systematic review synthesizes three decades of simultaneous EEG-neuroimaging, mapping convergent and divergent findings across modalities to advance understanding of sleep-state brain function.

AB - Sleep is a dynamic process involving complex changes in brain activity across distinct stages, yet the neurobiology of these transitions remains poorly understood. Simultaneous electroencephalography (EEG) and neuroimaging provide a unique window into stage-specific brain activity by combining the temporal precision of EEG with the spatial resolution of functional Magnetic Resonance Imaging (fMRI), Positron Emission Tomography (PET), and the signal specificity of Near-Infrared Spectroscopy (NIRS). We conducted the first systematic review of simultaneous EEG-neuroimaging studies of human sleep. Systematic searches across five databases identified 205 eligible studies. Eligible studies recorded simultaneous EEG and fMRI, PET, or NIRS during sleep in humans, with EEG-based staging; sequential acquisition and awake-only studies were excluded. Findings were grouped by imaging modality, sleep state (NREM, REM, transitions), sleep manipulation type, and population (healthy vs. clinical). The majority used EEG-fMRI (n=141), with smaller numbers employing EEG-PET (n=34), EEG-NIRS (n=26), and multimodal combinations (n=4). Despite heterogeneity in protocols and analyses, convergent findings highlight robust thalamic, precuneus and cingulate involvement across non-REM (NREM) stages, with additional modality-specific insights. REM sleep showed increased activity in limbic and paralimbic networks, alongside reduced activity in executive control regions. Studies varied in design (49% overnight-only, 20% nap-only), populations (74% healthy adults only), and staging approaches (61% using 30-sec epochs), with methodological challenges including small sample sizes (median N=18) and heterogeneity in sleep manipulation protocols (28% used sleep restriction). This systematic review synthesizes three decades of simultaneous EEG-neuroimaging, mapping convergent and divergent findings across modalities to advance understanding of sleep-state brain function.

KW - EEG-NIRS

KW - EEG-PET

KW - EEG-fMRI

KW - NREM sleep

KW - REM sleep

KW - Sleep neuroimaging

UR - https://www.scopus.com/pages/publications/105045174678

U2 - 10.1016/j.neuroimage.2026.122122

DO - 10.1016/j.neuroimage.2026.122122

M3 - Review article

AN - SCOPUS:105045174678

SN - 1053-8119

VL - 338

JO - NeuroImage

JF - NeuroImage

M1 - 122122

ER -

Mapping human sleep-state brain function with simultaneous EEG and neuroimaging: A systematic review

Abstract

Keywords

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