Until recently, both the purpose of the biological need for sleep and the mechanism by which the central nervous system eliminated metabolic waste products were unknown. The glymphatic system is the recently discovered macroscopic waste clearance system for the CNS, which predominantly functions during sleep states. Important implications for the glymphatic system exist for a significant proportion of neurological disorders, including traumatic brain injury, epilepsy, stroke, migraine, and Alzheimer’s disease. Within the limited amount of research pertaining to this novel system there exists controversy regarding several of the key structural and functional aspects of the glymphatic system. In this review we address evidence from both standpoints regarding the prominent debates surrounding the glymphatic system, including the functional differences in wakefulness vs. sleep, the role of glial aquaporin-4 water channels, and whether it reflects a convective flow or a passive diffusion process. The answers that underlie these questions will have crucial and distinct outcomes for the future of the glymphatic system and the disorders it has been implicated in. However, this review also summarizes the potential role of the glymphatic system in the development and progression of the aforementioned neurological disorders. Furthermore, the possible contribution of the orexinergic system to this relationship between the glymphatic system, sleep, and these neurological disorders is also explored. Overall, in order to develop and utilize therapeutic interventions centred around the glymphatic system we must first dedicate further investigation to elucidating these discrepancies and unanswered questions.

直到最近，人们对睡眠的生理需求的目的和中枢神经系统消除代谢废物的机制都还不清楚。淋巴系统是最近发现的中枢神经系统的宏观废物清除系统，主要在睡眠状态下起作用。对于很大比例的神经系统疾病，包括外伤性脑损伤、癫痫、中风、偏头痛和阿尔茨海默病，glymphatic 系统具有重要意义。在与这种新型系统相关的有限研究中，对淋巴系统的几个关键结构和功能方面存在争议。在这篇综述中，我们从两个角度讨论了关于围绕类淋巴系统的突出辩论的证据，包括清醒与睡眠的功能差异、胶质水通道蛋白 4 水通道的作用，以及它是反映对流还是被动扩散过程。这些问题背后的答案将对类淋巴系统的未来及其所涉及的疾病产生关键和独特的结果。 然而，本综述还总结了类淋巴系统在上述神经系统发育和进展中的潜在作用。障碍。此外，还探讨了食欲素能​​系统对淋巴系统、睡眠和这些神经系统疾病之间的这种关系的可能贡献。全面的，