Linking the nature and functions of sleep: insights from multimodal imaging of the sleeping brain

Sleep and wakefulness are traditionally considered as two mutually exclusive states with contrasting behavioural manifestations and complementary neurobiological functions. However, the discoveries of local sleep in global wakefulness and local wakefulness in global sleep have challenged this classical view and raised questions about the nature and functions of sleep. Here, we review the contributions from recent multimodal imaging studies of human sleep towards understanding the relationship between the nature and functions of sleep. Through simultaneous tracking of brain state and mapping of brain activity, these studies revealed that the sleeping brain can carry out covert cognitive processing that was thought to be wake-specific (wake-like function in the sleeping brain). Conversely, the awake brain can perform housekeeping functions through local sleep of neural populations (sleep-like function in the awake brain). We discuss how the blurred boundary between sleep and wakefulness highlights the need to radically rethink the definition of brain states, and how the recently discovered fMRI signatures of global and local sleep can help to address these outstanding questions.