Keywords
EEG, Brain State, Homeostasis, Neural Networks, Phase Coupling
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2
Abstract
Sleep and circadian rhythms both contribute to cognitive performance, but the underlying neuronal
network-level changes remain unclear. We quantified the contribution of brain state, sleep-pressure
dynamics across the sleep-wake cycle, and circadian rhythmicity to electroencephalographic (EEG)
functional connectivity (FC) and examined how these network changes relate to cognition. Thirty-four
healthy adults completed a 10-day forced-desynchrony protocol to uncouple sleep-wake and
endogenous circadian rhythms. From over 1,200 hours of artifact-free EEG, we derived phase-
coupling metrics to quantify FC across brain states, thirds-of-the-night (sleep pressure), and circadian
phase, and related these network measures to a range of cognitive performance indices. FC differed
markedly between brain states, especially in the alpha and sigma bands, and was modulated by sleep
history and circadian phase. Principal component analysis revealed both a global and a
topographically distributed FC component which responded differentially to sleep pressure. Dissipation
of sleep pressure was accompanied by increasing global FC in NREM sleep, and especially in the
delta, sigma and beta frequencies, and decreasing global FC in the alpha band. During REM sleep,
global FC decreased in nearly all frequency bands with dissipation of sleep pressure. The influence of
circadian phase on FC was smaller than that of sleep pressure and varied across brain states. Lower
global theta-band FC in NREM and alpha-band FC during wake predicted better alertness and working
memory accuracy, an effect modulated by circadian phase. These results suggest that sleep
homeostasis and circadian timing interact to stabilize functional brain connectivity in wakefulness,
thereby supporting optimal cognitive function.
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3
Significance Statement
Identifying how sleep restores neural networks degraded during wakefulness is of significance for
understanding sleep’s role in maintaining brain function. Here we used a protocol to isolate effects of
sleep from effects of circadian rhythmicity on functional connectivity of neural networks and assessed
associations with cognitive performance. We found that circadian rhythmicity but in particular the
dissipation of sleep pressure had profound effects on global connectivity which were different for
NREM sleep, REM sleep and wakefulness and varied across frequency bands. Connectivity measures
in the theta, alpha and sleep spindle frequency ranges were associated with cognitive performance.
These novel findings provide a new perspective on the nature of the sleep recovery process
contributing to the waking performance capability of human brains.
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4
Main Text
Introduction
Sleep is widely conceptualized as a recovery process, which returns neural network function degraded
by prior wakefulness toward a baseline state (1). Recovery may be understood mechanistically (e.g.
synaptic downscaling) or functionally (e.g. restoration of information transfer and integration capability);
yet exactly how recovery unfolds across sleep and circadian cycles remains poorly defined.
Oscillations in the electrical activity of the cortex are thought to reflect the fundamental
neurophysiological mechanisms enabling the temporal organization, transfer, and integration of
information in the brain which are essential for waking performance (2-5). Tracking how these rhythms
are restored or reshaped during sleep may reveal the network mechanisms of recovery.
In humans, this oscillatory activity can be assessed by intracranial recordings of unit activity or field
potentials and noninvasive techniques such as magnetoencephalography and electroencephalography
(EEG) (6, 7). The power spectrum of the EEG signal derived from single electrode sensors provides
information on the frequency composition of the oscillatory activity at the location of the sensors and
the underlying cortical neural firing rate and synchronicity (2).
The frequency composition and
amplitude of the EEG vary across and within brain states (wakefulness, NREM sleep, and
REM sleep)(8). Furthermore, both the sleep-wake cycle and circadian rhythmicity have been shown
to modulate brain oscillatory activity as quantified by power spectral analysis within each of the brain
states (9, 10). Among the most prominent modulations within vigilance states are the decline of slow
wave activity within NREM sleep from the beginning to the end of sleep episodes and an increase of
theta activity during wakefulness with elapsed time awake (11, 12). These dynamics of low-frequency
EEG activity, which are observed in many mammalian species, have been used extensively as
indicators of a recovery process during sleep and a buildup of sleep pressure/sleep debt and
associated deterioration of brain function during prolonged wakefulness (13). However, it has been
challenging to establish how the dynamics of slow wave activity relates to a sleep dependent recovery
process underpinning brain function during wakefulness.
Beyond the frequency distribution of the EEG signal measured by the power spectrum, the functional
integration of brain regions can also be characterised using connectivity metrics. A widely used
measure is the phase
‐ lag index (PLI) (14) which measures the consistency with which the phase of a
signal from one location leads or lags a signal from another location by ignoring phase differences
centred around zero. By taking the sign of the phase difference and averaging over time, PLI isolates
stable, non-instantaneous phase relationships that reflect genuine synchrony. A commonly used
extension of the PLI is the weighted phase
‐ lag index (wPLI), which not only discards phase differences
around zero but also weights each observation by the magnitude of the imaginary component of the
cross
‐ spectrum (Vinck et al., 2011). By emphasizing larger phase ‐ lag magnitudes, wPLI further
suppresses the influence of small, noise ‐ driven phase fluctuations and residual volume ‐ conduction
effects that can still bias the unweighted PLI. In practice, wPLI therefore provides a more robust
indicator of true, non
‐ instantaneous synchrony, and hence potentially causal interactions, between
cortical areas, strengthening our inferences about information transfer and integration across
distributed networks. A further refinement of this connectivity metric is the debiased weighted phase
lag index (dwPLI) which corrects for sample-size bias in wPLI and further reduces noise-driven inflation
of connectivity estimates. This yields a more stable and interpretable measure of non-instantaneous
functional connectivity (see Methods section).
EEG connectivity measures are often used in cognitive neuroscience research to investigate
associations between functional connectivity (FC) and brain function at single time points. Several
studies have identified changes in FC in specific networks, such as the attentional or default mode
networks, and their associations with performance on tasks that depend on these networks. Changes
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in FC are also associated with brain development and brain disorders, such as mild cognitive
impairment (MCI) and Alzheimer's disease (15-19).
EEG connectivity measures also vary across brain states, indicating that they do not just reflect
anatomical/structural connectivity but FC (15, 20, 21). One argument for the functional importance of
connectivity measures is the observation that the reduced responsiveness to external stimuli
associated with sleep is accompanied by decreased functional brain connectivity (22).
Whether FC measures of brain oscillatory activity in the various brain states are modulated by
dissipation and increase of sleep pressure and circadian rhythmicity has not been established. Finally,
it has not been established whether and how functional EEG connectivity measures relate to the well-
established sleep-wake and circadian rhythmicity-dependent modulation of brain function as quantified
by performance on a variety of cognitive tasks (23-25).
We aimed to clarify these questions and hypothesized that the physiological effects of both sleep
pressure (its dissipation and accumulation) and circadian phase would influence functional connectivity
(FC). We also hypothesize that FC will be linked to waking cognition. Given that brain oscillatory
activity exhibits brain-state (Wake, NREM, and REM) and frequency-specific patterns, we further
hypothesized that these effects would be specific to particular brain states and frequency bands.
The separate contribution of the sleep-wake cycle and circadian rhythmicity-driven process to the
restoration and deterioration of brain function cannot be assessed by analysis of sleep and
wakefulness under baseline conditions because under these conditions these processes are
entangled. Quantifying their separate contribution requires desynchronizing the sleep-wake cycle from
endogenous circadian rhythmicity driven by the suprachiasmatic nuclei and indexed by melatonin,
cortisol, and core body temperature rhythms (10, 11, 23, 26).
Here, we quantified the independent contribution of circadian rhythmicity, and the dissipation and
accumulation of sleep pressure (i.e., time elapsed in sleep and wake, respectively) to functional brain
connectivity (FC) as measured by an improved index of phase synchronization, i.e., debiased weighted
phase leg index (dwPLI) (27) in both sleep and wake and its association with cognition.
FC was quantified across more than 1,200 hours of artifact-free NREM and REM sleep and nearly 90
hours of wake EEG, alongside performance on tests of vigilance and working memory, and processing
speed. The data were collected in a 10-day forced-desynchrony protocol in 34 healthy young adults
(Fig. 1).
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Fig 1. Research protocol and EEG data analysis. (A) Raster plot of the 28- h forced desynchrony (FD) protoco
with a representative example of sleep-wake schedule (habitual bedtime: 00:00). Following an 8- hour adaptatio
night (ADn) and adaption day (FdW1) participants were scheduled to a 28-h sleep- wake cycle, including 9 hour
and 20 minutes of sleep (horizontal dark blue bars) and 18 hours and 40 minutes for wakefulness (horizontal ligh
blue bars). The 24- h variation of plasma melatonin concentrati on was assessed on three occasions, at baselin
(FdW1-FDn1), FdW4-FdN4, and FdW7- FdN7 to estimate the phase and period of the intrinsic circadian clock a
indicated by the GREEN line, which repre sent the estimated onset of melatonin. The red arrow pointing indicate
the start of each 24-hour-long melatonin sampling session. Vertical green bars indicate cognitive test session
included in the current analysis. The gradient color on the wake period , ranging from green (habitual timing) to re
(12 h out of phase), indicates circadian alignment of the wake periods with the FD protocol. The green and re
arrows to the right of the figure indicate the two wake periods (FdW2 and FdW5) included in the wak e EEG
analysis. During these two wake periods, each cognitive test session included two 2- minute Karolinsk
Drowsiness Tests (KDTs) to measure resting wake EEG at the start and end of the assessments. (B) Time cours
of sleep stages (top panel), power spectral density (PSD) (middle panel), and debiased weighted phase lag inde
(dwPLI) (bottom panel) measured during a baseline sleep episode in one participan
Warmer colors represent higher spectral power (logarithmic scale) and functional connectivity ( FC) as measure
by dwPLI. Temporal resolution is 10 seconds/pix el, each representing the average of the short- time Fourie
transforms of four segments of 4- s long, Hanning tapered windows with 50% overlap. Power spectral densit
(PSD) values were obtained by also averaging over the 12 channels (FP1, Fp2, F3, F4, C3, C4, T3, T4, P3, P4
O1, and O2) whereas dwPLI values were averaged over all 66 electrode pairs. (C) The amount of artifact- fre
Wake, NREM, and REM sleep EEG data (in minutes) anal yzed for each sleep episode throughout the 10-day-lon
forced desynchrony study. (D) The amount of artifact- free Wake EEG data (in minutes) analyzed for the baselin
(FdW2) and the 12-h out-of-phase (FdW5) wake episodes.
We conducted a comprehensive analysis involving principal component analysis (PCA) applied to th
functional-connectivity (FC) matrices derived from 66 electrode pairs and 21 cognitive outcom
measures. We found a global principal component (PC), reflecting widespread synchronization (globa
FC). The second PC reflected a topographically distributed connectivity (distributed FC). To relat
these network patterns to cognitive function, we conducted a PCA on the cognitive measures an
analyzed the first two cognitive PCs representing cognitive alertness and working memor
performance (PC1) as well as processing speed and working memory performance (PC2).
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We found that recovery of brain function during sleep is associated with an increase in global FC
during NREM sleep and a decrease during REM and to some extent in wakefulness during
spontaneous interruptions of sleep. The circadian day was associated with a reduction in global FC
during wakefulness in the alpha band, and this reduction associated with better cognitive performance.
Together, these data illuminate how sleep homeostasis and circadian timing orchestrate the recovery
of large-scale network connectivity, enabling optimal brain function upon waking.
Results
Effect of brain states, homeostatic sleep pressure, and circadian phase on functional EEG
connectivity spectra
We used linear mixed effects modelling to quantify the effects of the three consolidated brain states –
NREM, REM sleep, and wake – during the sleep episodes as well as the effects of time elapsed in
sleep (i.e., dissipation of sleep pressure) and circadian phase on power spectrum density (PSD) and
EEG connectivity measures (Fig. 2). NREM included NREM2 and slow wave sleep (SWS) following
common practice (Dijk at al. 1995, Lazar et al., 2015). Artifact-free EEGs recorded during 231 in bed
periods of 9h and 20 mins each, which were distributed across the circadian cycle, were analyzed for
12 electrodes (Fp1,Fp2,F3,F4,C3,C4, P3,P4,T3,T4,O1,O2) and 66 electrode pairs (combinations of 12
electrodes) and frequency bins between 0.5 and 32 Hz (Figs 1A -C). EEG connectivity was estimated
using the debiased weighted phase lag index (dwPLI), as well as additional PC metrics including
weighted phase lag index, phase lag index, imaginary coherence, and phase coherence (Fig S1). In a
first analysis step we averaged the absolute power spectrum density (PSD) across the 12 EEG
channels and connectivity metrics across all 66 individual intra and interhemispheric electrode pairs.
PSD averaged across EEG channels showed the known characteristics of brain states (Fig 2 A and
Dataset S1.csv). Alpha (8-12 Hz) activity was higher in wakefulness than in NREM and REM sleep;
delta (0.5-4 Hz), theta (4 - 8 Hz), and sigma (12-16 Hz) activity in NREM exceeded the corresponding
values in REM.
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Fig 2. Power spectral density and functional connectivity spectra across brain states and sleep episodes
The main effect of brain states on (A) power spec trum density (PSD) and (B) debiased weighted Phase Lag Inde
(dwPLI) across all sleep episodes (231 nights) and averaged across EEG channels and cannels pairs
respectively. The upper panels represent least- square means (Lsmeans) and standard error of the mean (SEM
(C and D) Effect size (Cohen’s f 2) of main effects of brain state on the PSD and dwPLI. (E and F) Effect size o
main effects of Elapsed time in sleep (red) and Circadian phase (blue) on PSD and dwPLI. (G and H) Effect size o
interactions between factors Elapsed time in sleep and Circadian phase on PSD and dwPLI. Colored triangles i
(A) and (B) indicate significant (P<.01) effects. Detailed statistical results are in Dataset S1.xlsx.
The dwPLI also varied significantly across brain states and frequency (Fig. 2B , Dataset S1.xlsx ). It
spectral profile was characterized by peaks in the alpha and sigma bands. Unlike PSD, dwPLI value
did not markedly decrease with increasing frequency. Brain state effects on dwPLI were mos
dominant in the alpha-sigma range as well as in the delta frequencies (Fig 2C ). Within the alpha band
dwPLI values were highest during wakefulness, lowest in REM sleep, and intermediate in NREM . I
the sigma range (12–16 /i1Hz), dwPLI peaked most strongly during NREM /i12 and SWS. Overall, brai
states were best distinguished by PSD in the delta and sigma bands (Fig. 2 A,C) and by dwPLI value
in the alpha and sigma bands (Fig. 2B,D). In a confirmatory analysis, we repeated this procedure usin
four additional FC metrics (imaginary coherence, phase coherence, phase ‐ lag index, and standar
weighted phase ‐ lag index and observed nearly identical brain state ‐ dependent spectral profiles
confirming that our findings are robust to the choice of FC measure (Fig S2A-E and Dataset S1.xlsx
For exploratory purposes, we also repeated the same analysis including all NREM substages in th
model (NREM1, NREM2, SWS as well as REM and wake during sleep) (Fig S3 and Dataset S2.xlsx).
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Mixed model analyses revealed significant (p<0.01) main effects of Time Elapsed in Sleep and
Circadian Phase on PSD across all frequencies (Fig. 2E , Dataset S1.xlsx). For dwPLI these effects
were much smaller and restricted to specific frequency bands (Fig. 2 F, Dataset S1.xlsx). The
sleep‐ pressure and circadian effects on dwPLI were substantially smaller than the effects of Brain
State (Fig. 2 D and F). For PSD, the strongest sleep ‐ pressure effects occurred in the delta and theta
bands, reflecting the well ‐ known decline of low ‐ frequency power during sleep, while the largest
circadian modulations peaked in the alpha (8-12 Hz) and sigma bands (Fig. 2 E). Except near 10 Hz
and 15 Hz, sleep ‐ pressure effects on PSD exceeded circadian effects. For dwPLI, sleep ‐ pressure
effects on connectivity were largest in the theta, and beta bands, with magnitudes similar to or larger
than circadian effects (Fig. 2 F and Dataset S1.xlsx). Circadian effects on dwPLI peaked in the low
delta (0.5–3 Hz) and a narrow sigma band (~13 Hz). Overall, dwPLI was less strongly influenced by
circadian phase than elapsed time in sleep. The interaction between brain state and both time elapsed
in sleep and circadian phase showed more similar effect magnitudes across PSD and dwPLI (Fig. 2 G
and H). This suggests that while sleep pressure and circadian phase may not independently affect FC,
their influence is strongly modulated by brain state.
A confirmatory analysis using four additional connectivity metrics, imaginary coherence, phase
coherence, wPLI, and PLI, produced effect-size profiles for elapsed time in sleep and circadian phase,
comparable to those observed with dwPLI (Fig S2 F and Dataset S1.xlsx). Some metrics, particularly
imaginary coherence and phase coherence showed steeper sleep-dependent effect sizes and smaller
circadian effects (Fig S2).
Because dwPLI provided a good balance between sensitivity to state-related changes and resistance
to volume-conduction artifacts, we retained dwPLI and excluded the other connectivity measures from
further analyses (see methods). We also did not pursue further analysis of power spectral density
(PSD), as these effects have already been well-documented in the existing literature
(9).
Principal components in the topographical distribution of functional connectivity
In the next step, we investigated the direction and topography of significant main effects of elapsed
time in sleep and circadian phase on functional connectivity (FC). Given the large number of
dependent variables (66 electrode pairs per brain state and frequency band), we first applied
dimensionality reduction using principal component analysis (PCA) on FC as estimated by dwPLI from
the 231 sleep episodes scheduled across the circadian cycle.
We conducted separate PCAs for each brain state NREM (Fig. 3), REM (Fig. 5), and wake during time
in bed (Fig. 7) and each frequency band, resulting in a total of 18 analyses. Across all six frequency
bands and three brain states, the PCA consistently identified one dominant component (PC1), which
explained between 30% and 64% of the variance (mean: 41%) (Table S1.xlsx). The second principal
component (PC2) accounted for 4% to 19% of the variance (mean: 9%). Overall, the combined
variance explained by the first two components was highest in NREM (mean: 55%), followed by REM
(mean: 49%) and wake during the sleep episode (mean: 45%) (Table S1.xlsx).
The correlation patterns between the principal components (PCs) and dwPLI values across individual
electrode pairs indicated that higher loadings on PC1 reflected increased ‘global connectivity,’
characterized by overall elevated dwPLI across all electrode pairs (Figs. 3A , 5 A, 7 A and Dataset
S3.xlsx). This pattern was consistent for PC1 across all frequency bands and brain states. In contrast,
PC2 exhibited a more differentiated topography, and the interpretation of high loadings varied by
frequency band and brain state (Figs. 3D , 5 D, 7 D and Dataset S3.xlsx). Accordingly, PC2 was
interpreted as reflecting ‘topographically distributed connectivity.’ We limited our subsequent analyses
to the first two principal components to optimize explained variance while controlling for Type
/i1 I error.
Although the second component explained a smaller proportion of variance, it was retained to mitigate
the risk of Type/i1 II error.
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1
Effects of sleep-pressure dissipation on global and topographically distributed functional
We conducted two mixed model analyses: a primary analysis focusing on the two principa
components (PCs) and an exploratory analysis examining connectivity in each electrode pa
separately.
The number, magnitude, and direction of the significant ( P<0.01) effects of elapsed time in s leep an
circadian phase varied with brain state, frequency, and PC / topography (Figs. 3, 5, 7 and Datase
S4.xlsx).
Fig. 3. Principal component analysis of functional connectivity (dwPLI) during NREM sleep: effects o
sleep progression and circadian phase. (A and D) Loading values of individual electrode pairs on PC1 an
PC2, for delta, theta, alpha, sigma, beta and gamma frequencies. Values between brackets along the vertical axe
represent the variance explained by the PC. (B and E) The modulation o f PC1 and PC2 by elapsed time in sleep
Least square means (LSMeans) and standard errors of the mean (SEM) are presented for each 186.7- minut
interval (i.e., one-third of the sleep episode), averaged across all studied circadian phases. (C and F) the circadia
modulation of PC1 and PC2, with LSMeans and SEM shown for each 60° (~4-hour) circadian phase bin, average
across all sleep intervals. Data are double plotted to enh ance the visualization of circadian rhythms. The gree
vertical line marks the dim-light melatonin onset (DLMO; 0° circadian phase), and the grey shaded are
represents the average melatonin profile. Type III fixed effe cts are reported, with only statistically significant p
values (α = 0.01) indicated. Detailed statistical results are provided in Dataset S4.xlsx.
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1
As the sleep episode progressed and sleep pressure decreased, global FC (PC1) during NREM slee
markedly increased in most frequency bands, except for alpha, where it slightly but significantl
decreased (Fig. 3 B). In contrast, topographically distributed connectivity (PC2) decreased across a
frequency bands except alpha, where it increased (Fig. 3 E). The exploratory analysis supported thes
findings, revealing that most electrode pairs showed a significant ( P<0.01) increase in coupling ove
the course of the sleep episode (Fig 4 A, B and Dataset S5.xlsx). T he widespread statistica
significance of the effect across the studied EEG channel pairs is reflected in the small median p-valu
(median p = 1.91 × 10 ⁻ ¹¹) calculated among all comparisons with p < 0.01. In accordance with th
Results
for PC1 (Fig. 3B) the electrode pair-based analyses showed that the delta and in particular th
sigma but also the beta band exhibited the strongest and most widespread increases in FC wit
decreasing sleep pressure (Fig. 4 A). Theta, alpha, and beta bands displayed a topographically spl
pattern, with some electrode pairs showing increases and others decreases in coupling (Fig. 4 A
Notably, in the theta band, long-range fronto-centro-temporal connections exhibited an elapsed time i
sleep-dependent increase in coupling, whereas long-range fronto-occipital and centro- occipita
connections showed a decrease over the course of the sleep episode. In the alpha band, elap sed
time-in-sleep-dependent increases were predominantly observed in interhemispheric connection
between homologous regions. Decreases in connectivity over the course of the sleep episode in th
alpha band were primarily found in fronto-occipital and long-range fronto-centro- parietal connection
(Fig./i14A and Dataset S4.xlsx).
Fig 4. Topographical patterns of functional connectivity (dwPLI) in NREM sleep as a function of slee
progression and circadian phase. (A) Red lines represent the magnitude of effect sizes for elapsed time i
sleep for electrode pairs, where a significant main effect of this predictor was observed (p < 0.01). Effect sizes fo
electrode pairs that showed a time-in-sleep–dependent increas e or decrease in functi onal connectivity are show
separately. The geometric mean and median p-value among all significant p- values are also indicated an
highlighted in red. (B) Representative examples of the effects of elapsed time in sleep on dwPLI. Lea st squar
mean (LSmeans) and standard error of the mean (SEM) are presented indicating sleep- dependent estimates a
each 186.7-minute interval (third of the sleep episode ) measured across all studied circadian phases. (C) Blu
lines represent the magnitude of effect sizes for elapsed time in sleep for electrode pairs, where a significant mai
effect of this predictor was observed (p < 0.01). The geometric mean and median p- value among all significant p
values are also indicated and highlighted in blue. (D) Representative examples of the effects of circadian phase o
dwPLI. LSmeans and SEM indicate circadian phase- dependent estimates at 60 degrees (~ 4 h) bins measure
across all studied sleep intervals and EEG derivations presenting a significant circadian modulation as shown in A
Data are double plotted to enhance the visualization of circadian rhythms. The green vertical line marks the dim
light melatonin onset (DLMO; 0° circadian phase), and the grey shaded area repres ents the average melatoni
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1
profile. Type III fixed effects are reported, with only statistically significant p- values (α = 0.01) indicated. Detaile
statistical results are provided in Dataset S5.xlsx.
REM sleep (Fig. 5 B and Dataset S4.xlsx), unlike NREM, showed a significant decrease in global FC
(PC1) with elapsed time in sleep across most frequency bands, except for alpha, where no significan
change was observed. In turn, topographical distributed FC (PC2) showed no significant effect of slee
pressure, except in the delta and beta frequency bands, where it increased with time elapsed in slee
(Fig. 5E).
Fig 5. Principal component analysis of functional connectivity (dwPLI) during REM sleep: effect s of slee
progression and circadian phase. (A and D) Loading values of individual electrode pairs on PC1 and PC2, fo
delta, theta, alpha, sigma, beta and gamma frequencie s. Values between brackets along the vertical axe
represent the variance explained by the PC. (B and E) The modulation of PC1 and PC2 by elapsed time in sleep
Least square means (LSMeans) and standard errors of the mean (SEM) are presented for each 186.7- minut
interval (i.e., one-third of the sleep episode), averaged across all studied circadian phases. (C and F) the circadia
modulation of PC1 and PC2, with LSMeans and SEM shown for each 60° (~4-hour) circadian phase bin, average
across all sleep intervals. Data are double plotted to enhance the visualiza tion of circadian rhythms. The gree
vertical line marks the dim- light melatonin onset (DLMO; 0° circadian phase), and the grey shaded are
represents the average melatonin profile. Type III fixed effe cts are reported, with only statistically significant p
values (α = 0.01) indicated. Detailed statistical results are provided in Dataset S4.xlsx.
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1
The exploratory topographical analysis supported the PC1 findings showing that all electrode pairs tha
exhibited a significant elapsed-time-in-sleep-dependent effect (median P = 5.91E-08) wer
characterized by a decreasing coupling over the course of the sleep episode (Fig. 6 A, B and Datase
S5.xlsx). The largest number of electrode pairs showing a significant decrease in connectivity wa
observed in the sigma band.
Fig 6. Topographical patterns of functional connectivity (dwPLI) in REM sleep as a function of slee
progression and circadian phase. (A) Red lines represent the magnitude of effect sizes for elapsed time i
sleep for electrode pairs, where a significant main effect of this predictor was observed (p < 0.01). Effect sizes fo
electrode pairs that showed a time-in-sleep–dependent increas e or decrease in functi onal connectivity are show
separately. The geometric mean and median p-value among all significant p- values are also indicated an
highlighted in red. (B) Representative examples of the effects of elapsed time in sleep on dwPLI. Lea st squar
mean (LSmeans) and standard error of the mean (SEM) are presented indicating sleep- dependent estimates a
each 186.7-minute interval (third of the sleep episode ) measured across all studied circadian phases. (C) Blu
lines represent the magnitude of effect sizes for elapsed time in sleep for electrode pairs, where a significant mai
effect of this predictor was observed (p < 0.01). The geometric mean and median p- value among all significant p
values are also indicated and highlighted in blue. (D) Representative examples of the effects of circadian phase o
dwPLI. LSmeans and SEM indicate circadian phase- dependent estimates at 60 degrees (~ 4 h) bins measure
across all studied sleep intervals and EEG derivations presenting a significant circadian modulation as shown in A
Data are double plotted to enhance the visualization of circadian rhythms. The green vertical line marks the dim
light melatonin onset (DLMO; 0° circadian phase), and the grey shaded area repres ents the average melatoni
profile. Type III fixed effects are reported, with only statistically significant p- values (α = 0.01) indicated. Detaile
statistical results are provided in Dataset S5.xlsx.
During the spontaneously occurring WAKE periods within the 9h20 min sleep episodes, the dissipatio
of sleep pressure led to a significant decrease in global FC (PC1), particularly in the theta, sigma, an
beta frequency bands (Fig. 7B and Dataset S4.xlsx). In the delta and alpha bands, global FC initiall
declined in the first half of the night but showed a subsequent increase during the final third of th
sleep episode. The effects on PC2 were characterized by an increase in topographically distributed FC
in the alpha band and a decrease in the beta band, with most other frequency bands showing a non
monotonic shift in FC across the sleep episode similar to PC1 (Fig. 7E and Dataset S4.xlsx).
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1
Fig 7. Principal component analysis of dwPLI- based functional connectivity during wakefulness in th
time-in-bed period: effects of sleep progression and circadian phase. (A and D) Loading values of individua
electrode pairs on PC1 and PC2, for delta, theta, alpha, sigma, beta and gamma frequencies. Values betwee
brackets along the vertical axes represent the variance explained by the PC. (B and E) Th e modulation of PC
and PC2 by elapsed time in sleep. Least square means (LSMeans) and standard errors of the mean (SEM) ar
presented for each 186.7-minute interval (i.e., one-third of the sleep episode ), averaged across all studie
circadian phases. (C a nd F) the circadian modulation of PC1 and PC2, with LSMeans and SEM shown for eac
60° (~4- hour) circadian phase bin, averaged across all sleep intervals. Data are double plotted to enhance th
visualization of circadian rhythms. The green vertical line marks the dim- light melatonin onset (DLMO; 0° circadia
phase), and the grey shaded area represents the average me latonin profile. Type III fixed effects are reported
with only statistically significant p-values ( α = 0.01) indicated. Detailed statistical results are provided in Datase
S4.xlsx.
The exploratory topographical analysis revealed that the number of electrode pairs showing
significant elapsed-time-in-sleep-dependent effect during wake was relatively small compared to REM
and NREM (Fig 8A and Dataset S5.xlsx). The electrode pairs which showed such a significant effect o
time in sleep were primarily characterized by a decline in connectivity over time, except for the alph
band, which showed both decreases and increases in connectivity throughout the sleep episode (Fi
1 4
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1
8A, B and Dataset S5.xlsx). T he only electrode pair showing a significant effect in the delta ban
exhibited an initial decline, followed by a return to baseline connectivity levels (Fig 8B).
Fig 8. Topographical patterns of functional connectivity (dwPLI) during wakefulness in the time-in- be
period as a function of sleep progression and circadian phase. (A) Red lines represent the magnitude o
effect sizes for elapsed time in sleep for electrode pairs, where a significant main effect of this predictor wa
observed (p < 0.01). Effect sizes for electrode pairs that showed a time-in-sleep–dependent increas e or decreas
in functional connectivity are shown s eparately. The geometric mean and median p- value among all significant p
values are also indicated and highlighted in red. (B) Repr esentative examples of the effects of elapsed time i
sleep on dwPLI. Lea st square mean (LSmeans) and standard error of the mean (SEM) are presented indicatin
sleep-dependent estimates at each 186.7-minute interval (third of the sleep episode ) measured across all studie
circadian phases. (C) Blue lines represent the magnitude of effect sizes for elapsed time in sleep for electrod
pairs, where a significant main effect of this predict or was observed (p < 0.01). The geometric mean and media
p-value among all significant p-values are also indicated and highlighted in blue. (D) Representative examples o
the effects of circadian phase on dwPLI. LSmeans and SEM indicate circadian phase- dependent estimates at 6
degrees (~ 4 h) bins measured across all studied sleep intervals and EEG derivations presenting a significan
circadian modulation as shown in A. Data are double plotted to enhance the visualization of circadian rhythms
The green vertical line marks the dim-light melatonin onset (DLMO; 0° circadian phase), and the grey shaded are
represents the average melatonin profile. T ype III fixed effects are reported, with only statistically significant p
values (α = 0.01) indicated. Detailed statistical results are provided in Dataset S5.xlsx.
Both global and distributed FC are modulated by circadian phase in a topographical, brain-stat
and frequency-specific manner
The circadian modulation of FC was statistically significant across all brain states
and frequency band
with fewer electrode pairs showing a significant modulation of FC compared to the effects of elapse
time in sleep (Fig 3C to Fig 8C and Dataset S4.xlsx).
In NREM sleep, global FC (PC1) in the delta band (Fig. 3 C) and topographically distributed FC (PC2
in the theta band (Fig. 3F ) showed significant circadian modulation, both peaking during the circadia
day, i.e. when plasma melatonin levels are low (Table S5.csv) . Exploratory topographical analysi
confirmed these effects and further revealed significant circadian modulation for some electrode pair
in all other frequency bands except in beta and gamma (Fig. 4 C and Dataset S5.xlsx). In the thet
band, significant electrode pairs were primarily clustered over centro-posterior cortical regions
whereas in the sigma band, effects were more prominent over fronto-central areas. FC generall
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peaked during the circadian day, except in the sigma band, where FC was highest during the circadian
night, i.e. when plasma melatonin concentrations are high (Figs. 3C).
In REM sleep, only global FC (PC1) in the alpha and beta bands showed significant circadian
modulation, peaking at the end of the circadian day, i.e. near the onset of the nocturnal surge in
melatonin (Fig. 5 C and Table S5.csv). Exploratory analysis confirmed strong circadian modulation in
the alpha band across multiple electrode pairs, peaking in the second half of the circadian day (Figs.
6C, D and Dataset S4.xlsx). In contrast, beta and gamma bands exhibited circadian modulation that
peaked during the circadian night.
During wakefulness within the sleep episode, circadian modulation of PC1 did not reach significance
(P>0.01) (Fig. 7C ), while PC2 showed significant modulation primarily in the theta and alpha bands
(Fig. 7F and Dataset S4.xlsx). Exploratory topographical analysis supported these findings, revealing a
limited number of electrode pairs, mostly in the alpha band, that exhibited significant circadian
modulation, all peaking during the circadian night (Figs. 8C, D and Dataset S5.xlsx).
In summary, FC during wakefulness tended to peak during the circadian night, whereas in NREM and
REM sleep, the circadian phase of peak FC varied by frequency band and principal component /
topography.
Alpha-band-specific global FC during wakefulness increases with time awake and is modulated
by the circadian timing of the wake period.
We next investigated whether an increase in sleep pressure associated with time elapsed since waking
up from a major sleep episode leads to changes in connectivity in wakefulness and whether these
changes are opposite to the changes observed when sleep debt dissipates. Wake EEG data collected
during 18h and 40 min wake periods starting either in the morning, i.e. at a circadian phase during
which humans normally are awake (FdW2), or in the evening (FdW5), as would occur during night shift
work (Fig 1A), were analysed in a subgroup 12 participants. Wake EEG segments were collected while
participants were resting with eyes open during the 2-min long Karolinska Drowsiness Tests (KDT)
immediately prior to and after each of six cognitive test sessions scheduled across the wake episode.
In total, 365 mins of artifact-free wake EEG segments were analyzed for FC (i.e.,
wPLI) from 44
electrode pairs (Fig 1D). This includes 24 rest EEG wake periods (i.e., KDTs) per person (2 KDTs per
cognitive test session per person). Given the limited statistical power inherent in our exploratory,
pilot-style analysis of wake-dependent functional connectivity, conducted to elucidate findings from our
more extensive sleep data, we took steps to balance Type
/i1 I and Type/i1 II error risks. First, we limited
the number of statistical tests by a priori focusing exclusively on the theta and alpha frequency bands,
given their well ‐ established associations with both sleep pressure (Finelli, Baumann et al. 2000) and
circadian phase (10) and we did not run secondary exploratory analysis. Second, we set our
significance threshold at the conventional α/i1 =/i1 0.05 to balance sensitivity and reduce the risk of
overlooking true effects (i.e., minimize Type/i1 II errors).
Despite the smaller dataset, PCA applied to the 45 electrode pairs across the 24 rest EEG wake
periods (i.e., KDTs) per person revealed two primary principal components, with interpretations similar
to those observed during NREM, REM, and wakefulness within the sleep episode (Figs. S3 A, C and
Table S1). Based on the PC loadings PC1 reflected a global FC component (Fig S4 A), while PC2
represented a topographically more heterogeneous distribute FC component (Fig S4 C and Dataset
S4.xlsx). A linear mixed-effects model including two within-subject factors, time elapsed in wake (thirds
of the day:
∼ 6-hour intervals) and wake period (FdW2 and FdW5), indexing sleep pressure
accumulation and circadian phase, respectively, revealed a significant main effect of time elapsed in
wake on PC1 in alpha and a significant interaction in both alpha and theta (Fig S4 B and Table S2). In
Alpha global FC showed a steep increase during the 12-hour out-of-phase wake period and followed a
non-monotonic pattern during the baseline day. In the theta band, global FC decreased during the
baseline wake period, whereas during the 12-hour out-of-phase condition it did not decline and
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1
remained overall higher than during baseline (Fig S4 B). No significant effects were observed on PC
(Fig S4D and Table S2).
Association of Sleep- and Wake-dependent Functional Connectivity with Cognition
Finally, we examined whether EEG-based functional connectivity (FC) measured during sleep (NREM
REM) and resting wake was associated with cognitive performance, measured in 1,421 cognitive tes
sessions collected across the forced desynchrony protocol (Fig. 9) . To reduce dimensionality, 2
cognitive outcomes were included in the analysis (Fig. 9B), spanning the Karolinska Sleepiness Scale
the Psychomotor Vigilance Test, and multiple N-back tasks (verbal, numerical, pictorial, and integrate
at 1-, 2-, and 3- back levels). Two principal components emerged (PC1 = 29% variance; PC2 = 18%
over an eigenvalue of 1, but only PC1 was retained for subsequent analyses due to its robust loading
and interpretability with higher scores indicating higher alertness and working memory accuracy (Fig
9A–B). Similarly, FC was represented by the PC1 for each brain state and frequency band extracte
as described before, only to reduce multiplicity.
Fig 9. Principal component analysis of cognitive performance and its associations with NREM, REM, an
wake functional connectivity. Cognitive performance was measured during the scheduled wake periods. In tota
six cognitive test batteries were conducted per wake period. The current PCA included the first cognitive tes
session following each sleep episode. (A) Explained variance ratio of principal components of cognitive tes
performance measured across 21 outcome measures cove ring multiple domains including sleepiness (Karolinsk
Sleepiness Scale, KSS), vigilance / sustained attention (Performance Vigilance Test, PVT), and working memor
(N-back tests). (B) L oading values of individual cognitive outcome measures variables for the PC1’ (‘Highe
cognitive alertness and working memory performance’ ) and PC2 (‘Slower processing but better working memor
performance’). Warmer colors indicate stronger positive colder colors stronger negative Pearson correlatio
coefficients. (C) Mean absolute SHAP values from random fo rest models assessing the association betwee
functional connectivity (FC) in sleep and cognitive performance (PC1) the subsequent way period across th
circadian cycle (N=226). Predictors correspond to the first principal component (PC1) of dwPLI- based connectivit
across 66 channel pairs during NREM and REM sleep, calculated separately for each frequency band. Slee
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18
episode (FdN1 to FdN7) was also included in the model . SHAP values represent feature relevance based on
game-theoretic Shapley values; their average absolute m agnitude reflects each predictor’s global importance in
cognitive outcome prediction. (D) Spearman correlations between PC1 of FC in the NREM theta and sigma bands
and PC1 of cognitive performance, computed for each sl eep episode (N = 34). (E) Mean absolute SHAP values
from random forest models assessing the association between functional connectivity (FC) measured in resting
wakefulness (Karolinska Drowsiness Test) and cognitive performance (PC1) within the corresponding cognitive
test session (N=133). Predictors correspond to the firs t principal component (PC1) of dwPLI-based connectivity
across 45 channel pairs during wakefulness. Additional variables, such as wake period (FdW1 vs FdW5) and time
spent awake (test sessions COG1 to COG6), were incl uded in the respective models. (F) Spearman correlations
between PC1 of FC in the wake alpha band and PC1 of cognitive performance, computed separately for each
cognitive test session and for both in-phase and out-of-phase wake periods (N = 12). Full statistical results are
reported in Table S3 to S6.
To investigate the relationship between NREM- and REM-dependent FC (PC1 – ‘global connectivity’)
and cognitive performance (PC1 – ‘alertness and working memory accuracy’) on the subsequent day,
we followed a two-step procedure. In the exploratory step, we applied both standard multivariate
association testing using ordinary least squares (OLS) regression and machine learning-based
prediction approaches, including linear regression as well as ridge, lasso, and random forest
regressions to identify relevant features (see methods). Despite differences in methodology, both
approaches highlighted similar predictors, suggesting convergence between statistical inference and
predictive modelling.
The exploratory models included FC PC1 scores across six frequency bands in both NREM and REM
(12 predictors), along with the sleep episode (FdN1 to FdN7) to account for repeated structure (N = 34;
226 observations in total) (Fig. 1A). Predictive accuracy ranged from R² = 0.29 (OLS) to –0.17 (lasso),
nonetheless, several converging associations appeared. In OLS, NREM-theta FC was negatively
related to cognition (
β = –0.97, p 0, p < 0.01) were positively related. These were also retained in the lasso model (Table S3).
Random forest models emphasized similar features, with SHAP rankings highlighting NREM-theta and
NREM-sigma (Spearman ρ = 0.69, p = 0.0095 vs linear rankings) (Fig. 9 C). Thus, across methods,
global FC in NREM-theta emerged as the most consistent inverse correlate of cognition, although
interpretability is limited by the weak predictive fit.
In a confirmatory step, we ran Spearman correlations between the top two FC predictors (NREM-theta
and NREM-sigma) and cognitive PC1, separately for each sleep–wake period. This analysis confirmed
that global FC in theta was negatively associated with cognitive PC1 while in sigma this association
was positive but considerably weaker and non-significant. The associations were further modulated by
the circadian timing of sleep–wake episodes (Fig. 9D and Table S4).
We next examined the relationship between wake-dependent FC PC1 scores measured during resting
wakefulness in the Karolinska Drowsiness Test (KDT) across six test sessions and two wake periods,
habitual wake (FdW2) and 12-h out-of-phase wake episodes (FdW5), and the corresponding cognitive
PC1 scores in a smaller pilot sample (N = 12; 133 observations in total). The initial exploratory
multivariate linear and non-linear regressions analyses included four predictors represented by wake-
dependent FC PC1 (global connectivity) scores in the alpha and theta bands as well as test session
(COG1–COG6) and wake period (FDW2, in-phase; FDW5, out-of-phase), given the repeated structure
of the data. The dependent variable was represented by the PCA-derived cognitive scores for cognitive
PC1 for each individual test session and studied wake period. Despite a poor predictive performance
(linear: R² = –0.08; RF: R² = 0.06) both linear regression coefficients and rankings consistently
identified WAKE-alpha FC as the most relevant predictor (Fig 9 E) with higher alpha FC predicting
poorer cognitive scores with strong significance (
β = –0.67, p < 0.00001, OLS), and was selected by
the lasso model (Table S5). Confirmatory Spearman correlation analyses between wake–alpha and
cognitive PC1 showed that alpha-band global FC was negatively and significantly associated with
cognitive performance, and this association was modulated by test session and the circadian timing of
the wake period (Fig 9F and Table S6).
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In summary NREM-theta connectivity (negative association) and wake-alpha connectivity (negative
association) emerged as the most consistent predictors of reduced alertness and working memory
efficiency. These findings highlight potential frequency-specific links between FC and cognition.
Discussion
Separation of sleep-wake and circadian contributions to brain oscillations demonstrates that functional
brain connectivity differs across sleep–wake states, is modulated by circadian phase, and changes
profoundly with the dissipation of sleep pressure. As sleep progresses, functional connectivity
increases during NREM sleep and decreases during REM sleep. Functional connectivity in specific
frequency bands during NREM as well as during wakefulness associate with cognitive performance.
These novel findings imply that sleep-dependent changes in functional connectivity are related to the
recovery of brain function during sleep.
Functional EEG connectivity across brain states
Although prior studies have reported sleep stage-dependent differences in EEG-measured functional
connectivity during nocturnal sleep, this is the first study to assess brain state (i.e. sleep stage) effects
while simultaneously controlling for both elapsed time in sleep and circadian phase. In addition, we
also controlled for the confounding influence of including short EEG segments in the analyses. As a
result, the brain state differences observed here may not align precisely with earlier findings, but it is
our view that the current approach provides a more accurate assessment of state specific changes in
functional connectivity.
The current approach revealed that wake EEG is characterized by a dominant peak in connectivity
within the broader alpha range and that connectivity in the alpha range is lower in NREM sleep and
lowest in REM sleep. Wakefulness, however, does not consistently exhibit higher connectivity than
other brain states across all frequency bands. For example, connectivity in the sigma band, which
primarily reflects sleep spindle activity, is highest in NREM2. Our results support earlier findings
indicating that alpha-band functional connectivity is a key feature distinguishing wakefulness from REM
sleep and may reflect the degree of disconnection from the external environment (28). Notably, our
results, indicate that EEG connectivity in REM sleep is lower than in slow-wave sleep (SWS) across
both the broader alpha and sigma bands, with no frequency band showing higher FC in REM
compared to all other brain states. These findings were very similar across the five connectivity
measures explored here.
One conclusion of the current findings is that rather than considering REM sleep a paradoxical wake’
state, it could be considered the least wake-like brain state and perhaps the deepest sleep stage.
Changes in functional EEG connectivity with time elapsed in sleep
The sleep-dependent decline in the PSD in the low-frequency range and in particular slow-wave
activity (0.75-4.5 Hz) in NREM sleep has for many years been used as a canonical EEG biomarker for
sleep homeostasis and the recovery processes occurring during sleep (12). Slow wave indices were
subsequently linked to electrophysiological and molecular markers of synaptic strength, which in turn
was linked to synaptic downscaling and the hypothesis that synaptic homeostasis is a core function of
NREM sleep (1). The current data demonstrate that the dissipation of sleep debt also has large effects
on connectivity measures in NREM sleep and across a wide frequency range. Given that connectivity
is also underpinned by functional and structural changes in cortical synapses, we expected some
similarities between FC and spectral power dynamics. Contrary to our expectations, connectivity in
NREM sleep increases with the dissipation of sleep debt, and in all frequency bands, except the alpha
band. This is in line with some reports showing an increase in connectivity from the first to the second
sleep cycle in young participants. (15). However, other researchers reported that connectivity in
NREM2 decreases as nocturnal sleep progresses (29). These previous studies, however, did not
control for circadian phase. Furthermore, focusing on NREM2 alone is insufficient to capture the full
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dynamics of functional connectivity modulation across all stages of NREM sleep. Topographical
distribution and differences across canonical frequency bands also need to be considered. Our data
indicate that while NREM sleep is generally marked by a global increase in connectivity, particularly in
the sigma band, i.e. in the frequency range of sleep spindles, there is also notable topographical
variation. Specifically, certain clusters of electrode pairs show sleep-dependent increases or decreases
in connectivity, which may represent region-specific specialized reorganization.
Whereas the increase in connectivity in delta and theta bands contrasts with the decreases in spectral
power in these bands, the very widespread increase in connectivity in the sigma band parallels the
sleep-dependent increase in sigma power (11). A possible explanation for the observed dissociation
between the sleep-dependent changes in power spectral density (PSD) and functional connectivity
(FC) in NREM lies in their distinct neurophysiological bases. PSD quantifies the local energy of
oscillations, though it can be inflated by volume conduction, whereas phase-based FC captures the
synchrony of activity across distributed regions within the same frequency band.
The observations that connectivity in REM decreased with the dissipation of sleep pressure while at
the same time NREM connectivity increased underlines the brain state specificity of the dissipation of
sleep pressure dependent changes in connectivity. This also highlights an important distinction
between functional connectivity and power spectral density measures, because for the latter measure
the direction of sleep pressure dependent changes in the lower frequency range are in general similar
for NREM and REM sleep (11).
Circadian modulation in connectivity
EEG connectivity in all brain states is influenced by circadian rhythmicity, but the magnitude and
direction of this circadian effect is dependent on brain state and brain topography. This is consistent
with previous findings showing circadian modulation of EEG measures, including slow-wave activity
and sleep spindle activity in NREM sleep, alpha activity during REM and wakefulness, and markers of
synaptic strength such as the slope of slow waves in NREM sleep, particularly in similar forced-
desynchrony protocols (10, 11, 25, 30, 31). Although the extent and phase of circadian modulation of
these EEG measures depend on brain state, frequency, and topography, our results show that the
dominant circadian rhythms of functional connectivity in wakefulness and NREM sleep are
approximately 12 hours out of phase. Specifically, connectivity during wake peaks at the circadian
night, whereas connectivity during sleep peaks at the circadian day.
Functional connectivity and cognitive performance
While the predictive power was weak and the findings should be interpreted with caution, FC during
sleep—especially NREM—and during the major wake period showed frequency-specific associations
with cognition. This is not surprising as the human brain operates as a network of functionally
interconnected regions, the connectivity of which is believed to underpin behavior, cognition, and mood
states (32).
However, our findings suggest that the relationship between network synchrony, as measured by EEG,
and cognitive performance is a non-trivial one. During NREM sleep, lower global connectivity in the
theta band and higher global connectivity in the sigma band (FC–PC1) were associated with better
subsequent alertness and working memory performance (cognitive PC1), independent of connectivity
in other frequency bands during either NREM or REM sleep. While the increased sigma coupling may
reflect more effective thalamocortical network interactions, the link between lower theta connectivity
and waking cognitive performance remains unclear.
Notably, previous work has shown that EEG-based functional connectivity in the theta and beta
frequency ranges increases with age, whereas connectivity in the sigma range decreases (Ujma et al.,
2019). Given that cognitive function normally declines with age, increased theta-band global
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connectivity may be considered a negative predictor of waking cognitive function, potentially an even
stronger one than sigma-based connectivity. This interpretation also aligns with findings in older
patients with obstructive sleep apnea where, higher relative frontal theta power during NREM stage 2
was negatively associated with Mini-Mental State Examination scores and was elevated in those with
mild cognitive impairment (Chen et al., 2023). These findings suggest that the cognitive benefits of
sleep arise from frequency-specific alterations in oscillatory coupling, with distinct roles for sigma- and
theta-band synchrony.
In contrast, during wakefulness, higher global alpha connectivity was associated with poorer
performance, consistent with previous reports linking excessive alpha synchrony to reduced neural
efficiency and impaired cognitive flexibility in both healthy aging and clinical populations (Klimesch,
2012; Babiloni et al., 2016). Resting-state alpha rhythms are generally slowed in mild cognitive
impairment, which has been associated with cognitive decline (33). Our observation that global alpha
connectivity decreases across sleep, but rebounds with extended wakefulness, may therefore reflect
an oscillatory signature of sleep-dependent recovery versus wake-related deterioration of neural
efficiency. Alternatively, some associations may reflect stable, trait-like relationships between the
brain’s functional neuroarchitecture and cognition (Touroutoglou, Andreano et al. 2015; Seitzman,
Gratton et al. 2019).
Speculative interpretation of the results – Connectivity and Criticality of brain states
Previous research (34, 35) suggests that optimal FC (and thus optimal brain performance) is achieved
when the brain operates near a critical state. This critical state supports a balance between flexibility
and stability, essential for cognitive processes and adaptability. Perturbations from this critical state,
whether due to anesthesia, sleep deprivation, or disorders of consciousness, result in less efficient
connectivity patterns. During wakefulness, connectivity levels may increase due to synaptic
potentiation, leading to disrupted (super)critical dynamics and less efficient states, whereas sleep acts
to restore critical dynamics(35). We demonstrate that the sleep-dependent recovery process is
characterized by a pronounced reduction in waking-state connectivity, particularly in the alpha band,
which has been linked to waking vigilance in both our and previous research
(10) . And ind eed , alpha
band emerges as a unique marker. Not only was alpha FC the only frequency to show a systematic
decrease over the course of both NREM and REM sleep, but daytime wake EEG also revealed that
lower global alpha connectivity strongly predicted better subsequent cognitive performance. This
robust negative relationship suggests that efficient network desynchronization in the alpha band, both
during sleep and wake, may index a neural state optimized for vigilance and information processing.
Although sleep recovery exerts broad, global effects on synaptic strengths, as described by the
synaptic homeostasis theory, the stage-specific patterns we observe (rising connectivity in NREM and
declining connectivity in REM) suggest that the renormalization of large-scale network interactions and
information-processing capacity depends on a coordinated, multi-phase recovery process rather than a
uniform downscaling. That is the coordinated alternation between NREM- and REM-mediated network
recalibration with opposite directions may be critical for rebalancing neural integration and information-
processing capacity. This aligns with theory suggesting that the inhibitory, collothalamic mechanisms
of NREM sleep, in nightly tandem with the excitatory, lemnothalamic mechanisms of REM sleep,
support the consolidation of new memories and their interleaved reconsolidation with existing memory
representations (36).
Limitations
and Strengths of the Current Study
The results presented here are based on a rigorous design and a large data set; nevertheless, the
study has several limitations. High-density EEG and source analysis which would have allowed a more
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22
comprehensive connectivity analysis was not implemented. As such, our EEG connectivity analyses
cannot directly be linked to distinct functional brain connectivity networks. Our experimental
manipulation was limited to sleep-wake timing. We did not perturb physiological brain activity and
connectivity via electric or magnetic stimulation.
Even though our EEG methodology may be limited, the data reveal aspects of the sleep process which
have not previously been reported. The finding presents a unique demonstration of the separate
contribution of the sleep-wake cycle and circadian rhythmicity to FC in wake, NREM and REM sleep.
Previous reports were based on small sample sizes, did not separate circadian and sleep-wake
dependent contributions and investigated effects of time awake by sleep deprivation which is a
challenge to the brain well beyond the challenges experienced during a normal sleep-wake cycle.
Previous studies have generally emphasized differences between brain states (e.g., wake vs.
NREM) or between sleep stages (e.g., NREM2 vs. SWS). In this large dataset, with repeated
measures of both EEG and cognitive performance, we focus on changes in connectivity
within brain states rather than differences between them.
We have done so because, in our view,
understanding how sleep contributes to recovery of brain function requires a description of the
dynamics of FC during the sleep episode, i.e. analyse how it changes from the beginning to the end of
sleep. Finally, our approach is unbiased because we considered many different frequency bands
rather than focusing on only one or two frequency ranges.
Concluding Remarks
Together, these findings suggest that when the sleep–wake cycle is aligned with circadian rhythmicity,
the interaction between sleep homeostasis and circadian processes supports the maintenance of
optimal brain connectivity. This balance may be disrupted during misalignment, which could contribute
to cognitive performance deficits and neurological conditions associated with disturbances of sleep and
circadian rhythms.
For many decades, sleep-wake and circadian aspects of brain function were quantified by sleep
staging and simple EEG analysis methods that are dependent on amplitude characteristics of the EEG.
More recently amplitude independent measures, such as coherence, were introduced. However, these
measures are confounded by volume conduction. These approaches revealed canonical aspects of the
sleep process, although it remained to the larger extent unclear how these aspects of the EEG and
sleep process associate with brain function. Novel approaches to EEG analysis, such as those used
here, combined with comprehensive assessment of brain function, implemented in protocols that
separate the contribution of sleep and circadian rhythmicity may provide new insights into the process
by which sleep and circadian rhythmicity interact to maintain homeostasis of brain function.
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Materials and methods
The study was approved by the University of Surrey Ethics Committee and conducted in accordance
with the Declaration of Helsinki. Written informed consent was obtained from all participants prior to
their enrolment.
Study protocol
The circadian and sleep-wake time-dependent modulation of EEG oscillatory was assessed using a
10-day forced desynchrony (FD) protocol, conducted in the Surrey Sleep Research Centre at the
University of Surrey. The protocol and associated procedures have been described in detail elsewhere
(25, 30, 31). Briefly, following a baseline day (FdW1) and night (FdN1), participants were scheduled to
a 28-h sleep-wake cycle comprising 18 h and 40 min of wakefulness in dim light (< 5 lx) and 9 and 20
min of sleep opportunity in darkness (Fig 1a). Throughout the 10-day period, participants resided in the
clinical research facility and followed a standardized routine including scheduled mealtimes and
cognitive testing sessions without access to information about clock time. Participants were
continuously monitored during wake periods by a member of staff to ensure wakefulness and followed
a strict schedule without physical exercise. During the scheduled wake periods, participants spent
most of their time in a lounge where they were allowed to chat with each other or with a member of
staff, listen to music, and watch movies and TV series from a pre-selected list.
The assessment of the circadian phase
Blood samples were collected hourly during the 1st, 4th, and 7th 28-h forced desynchrony sleep-wake
cycles (FdW1, FdW4, and FdW7) for determination of melatonin concentrations and assessment of
circadian phase (25, 30, 31) (Fig 1a). Blood melatonin concentration was quantified using
radioimmunoassay (Stockgrand Ltd, Guildford, UK). The time corresponding to the 25% of the daily
melatonin amplitude range [dim light melatonin onset (DLMO)] was assigned circadian phase zero (37,
38). Circadian period was derived from the linear regression fitted to the 3 DLMOs measured at FD1,
FD4, and FD7 for each participant (τ = 24 h + slope) (39).
Assignment of circadian phase and elapsed time in sleep and time in wake period to dependent
variables
To estimate the independent contribution of circadian phase and time since the start of the sleep and
wake episodes, to the outcome measures, we grouped the continuously recorded EEG data into time
bins and assigned to each of those time bins a circadian phase and the sleep-wake dependent index
as described earlier (25, 30).
PSD and connectivity measures were computed for all consecutive 20-minute intervals from the start
to the end of each sleep episode. We then assigned a circadian phase and a time since the start of the
sleep episode to each of the 20-minute intervals. For this, we used the 9 h 20 min sleep episodes
across FdN1 to FdN7. In the next step, data from the sleep and wake epochs (e.g., wake, NREM,
REM) and the consecutive 20-minute intervals (spectral data and connectivity measures) were
averaged in 6 circadian phase bins, each of 60° (~ 4-hourly bins), and three sleep-dependent time bins
(around 186.7 mins each) for each sleep episode.
For the wake-duration-dependent EEG analysis, we used the resting state wake EEG data collected
during the Karolinska Drowsiness Tests (KDT) with eyes open and fixating a point for two minutes.
These KDT sessions were scheduled immediately prior to and following each of the six cognitive test
sessions during the 2
nd and the 5 th wake period. The 2 nd wake period started at habitual wake time
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(e.g. approximately 8am) and the 5 th wake period started 12 hours later (Fig 1). Similar to the sleep-
duration-dependent analyses, the wake data were averaged per third of the 18h-40 min wake periods.
Assessment of cognition
Participants completed approximately 40 /i1 minutes of computerized cognitive testing at three-hour
intervals. For the present analyses, we examined subjective sleepiness using the Karolinska
Sleepiness Scale (KSS; administered at the beginning and/or end of each session), objective vigilance
and sustained attention via the 10-minute Psychomotor Vigilance Test (PVT), and working memory
and executive function using 1-, 2-, and 3-back tasks. A detailed description of these measures has
been published elsewhere(25, 40). The KSS is a 9-point Likert scale ranging from 1 (extremely alert) to
9 (very sleepy), with higher scores indicating higher levels of subjective sleepiness. From the PVT, we
derived four outcome measures: mean reaction time (RT), number of lapses (RT
/i1 >/i1 500/i1 ms), and
the inverse of the slowest and fastest 10 /i1 % of RTs. For the n-back tasks, performed in four variants
(integrated, pictorial, spatial, and verbal), we extracted two main outcome measures for each variant:
RT and A
′ (A-prime). A ′ is a nonparametric sensitivity index that quantifies a participant’s ability to
discriminate targets (hits) from non-targets (false alarms), ranging from 0.5 (chance performance) to
1.0 (perfect discrimination).
Polysomnographic (PSG) and wake EEG assessment
EEG was recorded throughout the forced desynchrony protocol during both sleep episodes and
repeated cognitive test sessions during the wake episodes. For the current analyses, we analyzed the
complete EEG data acquired during 231 sleep episodes from 34 participants (18 females, age: 25.1 ±
3.4). All participants presented a healthy sleep profile based on their baseline adaptation night which
also served as a clinical sleep screening with a full clinical EEG-PSG setup (12 EEG channels, EOG,
EMG, thoracic belt, a nasal airflow sensor, a microphone, and leg electrodes). During the FD protocol,
sleep and wakefulness were monitored by basic polygraphy (EMG, ECG, and EOG) with extended
monopolar EEG montage which covered the major brain areas (Fp1, Fp2, F3, F4, C3, C4, T3, T4, P3,
P4, O1, and O2) following the international 10–20 system. The ground and common reference
electrodes were placed at FPz and Pz, respectively. Two referencing schemes were applied. For
power spectral density (PSD) analysis, EEG derivations were re-referenced offline to the contralateral
mastoid (A1 or A2). For connectivity analyses, a common reference was used across all connectivity
metrics. Polysomnographic (PSG) data were recorded using Siesta 802 amplifiers (Compumedics,
Abbotsford, Victoria, Australia).
During the scheduled wake periods, EEG data were collected using the TEMEC Vitaport 3 system
(TEMEC Instruments B.V., Kerkrade, The Netherlands). The EEG montage was similar to the montage
used for the sleep EEG recording except that Fp1 and Fp2 channels were not used due to eye blinking
artifacts. For the current analysis, wake EEG from twelve participants out of 34 were included in the
analysis (nine men, and three women). This is because the paper focuses on the sleep data, while the
wake EEG analyses represent a pilot investigation. The participants whose EEG data were analyzed
did not differ from the rest of the sample in terms of demographic characteristics or baseline sleep
parameters.
EEG data were stored at 256 Hz. The low-pass filter was set at 70 Hz and the high-pass filter was set
at 0.3 Hz. Electrode impedance was kept below 5 k Ω . As reported earlier (30) sleep staging was
performed in 30 s epochs according to the Rechtschaffen and Kales criteria (41) by one experienced
sleep researcher (ASL) whose scoring showed a concordance exceeding 90% when compared to a
standard scored data set.
EEG power spectrum and connectivity analyses
All artifact-free EEG segments of the sleep stages of interest (WAKE, NREM1, NREM2, SWS, REM)
were concatenated within consecutive 20 min time intervals between lights out and lights on spanning
9 hours and 20 minutes (28 intervals) sleep episode. In total, 76,264 min (1771 hrs) artifact-free EEG
sections were analyzed for the sleep episodes including 58,155 min for NREM and 18,109 min for
REM as well as 4865 min for WAKE in the sleep episode and 365 min in the KDTs during the wake
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episodes with some modulations across the circadian cycle (Fig 1C and D). From the resting state
wake EEG data, we processed a two-minute-long EEG segment recorded immediately before and a
similar interval recorded immediately after each cognitive test battery.
We chose spectral methods to enable direct examination of frequency-specific effects, allowing us to
assess how the circadian-homeostatic interaction modulates functional connectivity in each canonical
EEG band. While non-spectral methods combined with bandpass filtering can also provide frequency-
targeted estimates, spectral methods offer native, direct frequency resolution, superior phase
accuracy, and methodological clarity (42).
Values were either analyzed on a 0.5 Hz bin basis to investigate spectral profiles between 0.5 to 32 Hz
or averaged over commonly used frequency bands: delta (0.5-4 Hz), theta (4-8 Hz), alpha (8-12 Hz),
sigma (12-16Hz), beta (16-25), and gamma (25 - 32 Hz). All measures were computed across
standard EEG frequency bands (delta, theta, alpha, sigma, beta, gamma) and separately for each
brain state. Computations used Python’s NumPy and SciPy packages (43, 44).
Detailed descriptions of the Power Spectral Density and Local Connectivity measures are provided in
the Supplementary Appendix.
Evaluation and selection of functional EEG connectivity metrics
While we ran the initial analysis characterizing the spectral profile of FC across different brain states
using five different connectivity measures, we chose to run the in-depth analysis using dwPLI. The
choice of dwPLI as the primary connectivity metric is well-supported by its correlation profile. It exhibits
a very high Pearson correlation with wPLI (0.95) and strong correlations with PLI (0.81) and ImCoh
(0.66), suggesting that it effectively captures the core aspects of phase-based connectivity shared
across these widely used measures. At the same time, its low correlation with phase coherence (0.10)
confirms its resistance to volume conduction and common source artifacts, which often inflate
coherence-based estimates. This balance between specificity and robustness makes dwPLI a
particularly suitable choice as it summarizes the essential structure of inter-regional interactions
without being compromised by methodological limitations inherent in simpler or more artifact-prone
metrics.
The selection of dwPLI was further supported by superior fit statistics for the mixed
‐ effects model,
specifically lower Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) values,
compared to those obtained using ImCoh.
Principal component analysis of functional brain connectivity and cognition.
We applied Principal Component Analysis (PCA) to the large, multivariate datasets related to FC and
cognition including all electrode pairs and sleep/wake episodes to reduce dimensionality and
investigate their underlying structure and relationships. For the FC data PCAs were run separately for
each brain state and frequency band. The employed imputation strategy for handling missing values in
the datasets consisted of removing all rows containing missing data. All columns were standardized to
ensure that all variables contributed equally to the analysis. In this instance, standardization was
applied by dividing each feature by its standard deviation. PCA was then conducted using a specified
number of principal components; in this case, 10 components were chosen to represent the underlying
structure of the data.
After fitting the PCA model, we extracted the component loadings and scores and calculated the
explained-variance ratio for each component to quantify the proportion of total variance accounted for.
Across all EEG connectivity matrices, PC
/i1 1 captured the majority of meaningful variance and was
marked by a distinct elbow in the scree plot. In a few frequency bands during NREM and wakefulness,
PC2 also accounted for a relatively large share of variance (>10%). All remaining components each
explained less than 5
/i1 % of the variance. In line with common PCA practices (e.g., Kaiser’s criterion
and the scree test) and to maintain consistency across brain states and frequency bands, we therefore
retained only the first two components for all subsequent analyses.
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To examine the association between FC and cognitive performance, a principal component analysis
(PCA) was first conducted across all cognitive test sessions, in line with the approach used for FC. In
the first analysis, which focused on the association between sleep-dependent FC and cognitive PC1.
The cognitive PC scores were analyzed as averaged for the entire wake episode (i.e., 6 test sessions)
following each sleep episode (see Fig. 1A). In contrast, the second pilot analysis, targeting the
association between FC measured during habitual (FdW2) and out-of-phase (FdW5) wakefulness
episodes (Fig. 1A) and cognition, included both FC and cognitive PC scores from all six cognitive
assessments conducted within each wake episode. Only the first principal component from the
cognitive PCA was retained, reducing dimensionality while preserving the main axes of variance
relevant to our outcome.
Statistical analysis
All analyses were conducted in SAS 9.4 and visualized using GraphPad Prism 9.
Power and Connectivity spectrum analysis
In the first analysis, the dependent variables were spectral power and electrode-pair connectivity,
measured with five metrics (coherence [COH], imaginary coherence [ImCOH], phase-lag index [PLI],
weighted PLI [wPLI], and debiased wPLI [dwPLI]), computed at 1
/i1 Hz resolution across each sleep
stage (NREM1, NREM2, slow-wave sleep, REM, and wake) during the scheduled sleep episodes. The
PSD and connectivity outcome measures were averaged across all EEG channels and channel pairs,
respectively, as topography was not evaluated at this stage. To examine the influence of circadian
phase, elapsed time in sleep, and sleep stage on these dependent measures we conducted linear
mixed-effects modelling for each log transformed PSD and connectivity outcome measure across the
frequency spectrum and across all 231 scheduled sleep episodes. The fixed effects included three
within-subject factors: circadian phase (six levels, using 60° bins), elapsed time in sleep (divided
into three approximately 3.1-hour intervals), and sleep stage (Wake, NREM1, NREM2, NREM3, and
REM). To accommodate the repeated measures structure of the data, we created a composite factor
representing each unique combination of these three conditions and treated this as the unit of
repetition nested within each participant and session. Random intercepts were included to account for
inter-individual differences, and a compound symmetry covariance structure was specified to model
within-subject correlations across repeated measurement occasions. To improve the accuracy of
standard error estimates, we used the Kenward–Roger method for degrees of freedom estimation. The
analysis focused on estimating and testing the main effects of each factor on connectivity as well as
the two-way interactions of factors sleep stage with circadian phase and elapsed time in sleep . To
control for Type
/i1 I error, the significance threshold was adjusted to α/i1 =/i1 0.01 (see section on
Correction for Multiplicity).
Topographical analysis of EEG connectivity
The topographical analysis comprised two consecutive steps. In the primary analysis, the dependent
variables were the principal component (PC) scores derived from a PCA on dwPLI-based
electrode-pair connectivity. Connectivity was calculated within six canonical frequency bands (delta,
theta, alpha, sigma, beta, and gamma) across three consolidated brain states (NREM, REM, and
Wake) during 231 sleep episodes, and during baseline wakefulness (FdW2) and 12
/i1 h out-of-phase
wakefulness (FdW5) in a subset of participants. Although the PCA reduced the 66 individual
electrode-pair connectivity values to a smaller set of components, the original PC loadings enabled
topographical interpretation of each component.
For the sleep episodes, we focused on the first two PCs, three brain states, and six frequency bands,
yielding 2
/i1 ×/i1 3/i1 ×/i1 6/i1 =/i1 36 unique models. Each model examined a single PC, brain state and
frequency-band combination. To control for Type /i1 I error, the significance threshold was adjusted to
α/i1 =/i1 0.01.
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For the wake EEG data (measured during the two wake episodes), we again used the first two PCs but
restricted our analysis to the theta and alpha bands, given their established roles in homeostatic and
circadian modulation, resulting in 2 /i1 ×/i1 2/i1 =/i1 4 models, each examining a single PC–frequency-band
combination. To balance statistical rigor with our small exploratory sample (N/i1 =/i1 12) due the intensive
manual artifact rejection required, we limited the number of tests and set the significance threshold at
α/i1 =/i1 0.05.
In the second step, we conducted a more exploratory topographical analysis by examining
dwPLI-measured connectivity for each electrode pair individually. In both the primary and the
secondary analyses, we applied the same linear mixed-effects modelling approach across brain states
and canonical frequency bands. The fixed effects included two within-subject factors: circadian phase
(six levels, using 60° bins) and time elapsed in sleep (divided into three approximately 3.1-hour
intervals).
For the sleep data, comprising 66 EEG channel pairs, three brain states (NREM, REM, and Wake),
and six frequency bands, this resulted in 66
/i1 ×/i1 3/i1 ×/i1 6/i1 =/i1 1/i1 188 unique models. For the wake EEG
data during the two wake episodes, comprising 45 channel pairs and two frequency bands, we tested
45
/i1 ×/i1 2/i1 =/i1 90 models. Each model analysed a single channel–state–band combination.
Since each subject contributed up to seven sleep episodes (SEs), and within each SE up to three
sleep intervals (i.e., thirds of the night), we specified a compound-symmetry (CS) covariance structure
on time elapsed in sleep nested within circadian phase (i.e., repeated ElapsedTimeInSleep
(CircadianPhase) / subject = Subject*SE type = CS) to parsimoniously model within-episode
correlations.
For the analysis of connectivity during the two wake episode, the two within-subject factors were
elapsed time in wake (divided into thirds of each wake period) and wake episode (in-phase vs.
out-of-phase), including their two-way interaction. Mixed models included a random intercept for each
participant to account for between-subject variability. Model degrees of freedom were adjusted using
the Kenward–Roger method (ddfm = kr) to improve the accuracy of standard errors and test statistics.
Association analysis between Connectivity and Cognition.
All multivariate analyses were conducted in Python (v3.8) (45) using standard scientific computing
libraries, including numpy, scipy, pandas, scikit-learn, statsmodels, and shap (46-48) . Functional
connectivity was calculated using the debiased weighted Phase Lag Index (dwPLI), separately for
NREM, REM, and resting wakefulness. For each frequency band and sleep–wake stage, 66 (sleep) or
45 (wake) channel-pair values were reduced via principal component analysis (PCA) to a single latent
feature: the first principal component (PC1), representing global connectivity for that condition.
Cognitive performance was likewise reduced through PCA across 21 behavioral outcomes spanning
sleepiness ratings, vigilance, and working memory tasks. The first cognitive component (PC1),
interpreted as a general alertness and working memory factor, served as the target variable. For sleep
analyses, PC1 scores were averaged across the six behavioral sessions following each sleep episode.
To examine the relationship between functional connectivity and cognition, a two-step analysis was
applied. In the exploratory phase, both association and prediction models were employed. Multivariate
association was assessed using Ordinary Least Squares (OLS) regression via the statsmodels
package, yielding estimated regression coefficients, p-values, and 95% confidence intervals. In
parallel, prediction was performed using linear regression, ridge regression with cross-validated
regularization strength (49), lasso regression (also with CV-based regularization) (50), and random
forest regression with 100 estimators (51). Feature values were standardized before modeling. The
outcome variable was negated prior to training to align the direction of prediction across datasets.
Subject identity was optionally included as a predictor to evaluate the extent to which individual
baselines influenced model performance.
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To avoid data leakage, an 80/20 train/test split was used, ensuring that data from a given participant
appeared only in one of the sets. Train/test splits were group-aware and stratified by subject identity.
Missing values were handled via mean imputation. To interpret feature relevance in tree-based
models, SHAP values were computed using the shap package. SHAP (SHapley Additive exPlanations)
is a method for quantifying the contribution of each feature to model output, based on cooperative
game theory, and is conceptually related to feature importance measures but offers consistent, model-
agnostic attributions (52-54).
In the confirmatory phase, the most relevant predictors identified during the exploratory phase were
tested using univariate Spearman correlations with cognitive PC1 scores, calculated separately for
each sleep–wake episode. Spearman correlations were performed in SAS 9.4.
Output and Diagnostic Tracking
For each model, we extracted key analytical outcomes, including the estimated least-squares means
for the levels of both predictors, Type III tests of fixed effects (F -values and associated p-values), and
standard fit statistics such as AIC and BIC. We also recorded the residual skewness of the fitted model
and documented whether the final model used a log-transformed or untransformed outcome variable.
To visualize statistical effect sizes, we calculated Cohen's f2 effect size (55):
f2 = u/v/i1 ∗ /i1 F,
where u and v are, respectively, the numerator and denominator degrees of freedom of the F statistic
used to determine the corresponding main or interaction effect in the general linear mixed model
analysis.
In the model ‐ selection process, we evaluated the residual ‐ distribution diagnostics, checked for
convergence issues (e.g., infinite likelihood), and compared fit statistics, namely the Akaike Information
Criterion (AIC) and the Bayesian Information Criterion (BIC). The model exhibiting the lower AIC and
BIC was retained as the final model. Correlational analysis was based on Spearman correlations.
Correction for Multiplicity
We conducted a large number of statistical tests across several multivariate models. Although these
tests were not entirely independent, we addressed the risk of Type /i1 I error through multiple strategies.
First, we set a more stringent significance threshold at α/i1 =/i1 0.01. Second, in our primary
topographical analysis, we further limited the number of comparisons by reducing dimensionality via a
PCA and only the PCs derived from the dwPLI connectivity data were tested. Third, we then carried
out an exploratory channel-pair analysis to confirm the primary results, and throughout both stages we
reported P
/i1 values alongside standardized effect sizes, anchoring our main conclusions on the largest
and most statistically robust effects.
To contextualize our chosen α/i1 =/i1 0.01 relative to a conventional multiplicity correction, we also
applied the Benjamini–Hochberg procedure (FDR /i1 =/i1 5%). Across all 5100 individual p-values, the
largest p-value passing the Benjamini–Hochberg critical threshold was 0.021. Thus, under the
Benjamini–Hochberg procedure, tests with p /i1 </i1 0.021 would be deemed significant. Our choice of
α/i1 =/i1 0.01 is therefore more conservative than controlling the false discovery rate at 5%.
For the wake ‐ episode data, given the smaller sample size and the need to balance Type /i1 I and
Type/i1 II error risks, we reduced the number of analyses and set the significance threshold at the
conventional α/i1 =/i1 0.05.
Acknowledgments
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29
This research was supported by a Biotechnology and Biological Sciences Research Council grant
(BB/F022883; PI: DJD). DJD is supported by the UK Dementia Research Institute core awards UKDRI-
7005 and CF2023\7 and award UKDRI-7206 , through UK DRI Ltd, principally funded by the UK
Medical Research Council; and by the National Institute for Health Research (NIHR) Oxford Health
Biomedical Research Centre (BRC), (NIHR203316) . ASL received funding from the Wellcome trust
(207799/Z/17/Z) and UKRI (ES/W006367/1) and NIHR (NIHR206949). We thank the staff of the Surrey
Clinical Research Center for their help with recruitment, screening and clinical conduct of the study.
Drs Ana Slak, Sibah Hasan for their help with data acquisition.
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