THE ROLE OF REM SLEEP IN CONSOLIDATING EXECUTIVE FUNCTION: A PREFRONTAL CORTEX PERSPECTIVE

Abstract

Background: Rapid Eye Movement (REM) sleep plays a critical role in the consolidation of higher-order cognitive functions, particularly those governed by the prefrontal cortex (PFC), such as working memory, inhibitory control, and cognitive flexibility. Given the increasing evidence linking sleep quality with executive performance, this study investigates how REM sleep influences these essential functions and how sleep disruption may lead to cognitive and emotional impairments.

Objective: To examine the relationship between REM sleep quality and executive functions—including working memory, inhibitory control, and cognitive flexibility—and to evaluate how sleep disruptions affect these cognitive domains.

Methods: A cross-sectional observational study was conducted between July and September 2024, involving 145 Pakistani adults aged 18 to 70 years. Participants were recruited using convenience sampling. The Pittsburgh Sleep Quality Index (PSQI) was utilized to assess overall and REM-related sleep quality, while executive functioning was measured using the Frontal Assessment Battery (FAB). Stress levels and cognitive failures were also evaluated. Pearson and Spearman correlation analyses were performed based on normality distribution (p < 0.05).

Results: A significant positive correlation was found between REM sleep quality and executive function performance (r = 0.452, p < 0.01). Participants sleeping 7–8 hours reported the highest FAB scores (mean = 11.03 ± 1.98), while those sleeping less than 5 hours had the lowest (mean = 9.18 ± 3.46). Cognitive failure was most prevalent among individuals with <5 hours of sleep (mean = 57.00 ± 23.59), who also reported elevated stress levels (mean = 7.18 ± 3.19). Females exhibited higher cognitive failures (mean = 33.12 ± 19.21) and stress (mean = 5.70 ± 2.55) compared to males. Older adults showed slightly lower frontal lobe functioning compared to younger participants.

Conclusion: REM sleep strongly contributes to the consolidation of executive functions by enhancing PFC-related synaptic plasticity. Disrupted REM sleep is linked to impaired cognitive flexibility, working memory, and emotional regulation, suggesting that improving sleep quality may serve as a vital strategy for cognitive enhancement.