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(iii) the effect of sleep stage on the formation of immunological memory through specific immune-active hormones: indeed, during slow wave sleep-rich early sleep, the profile of immune-active hormones, characterized by minimum concentrations of cortisol, endowed with anti-inflammatory activity, and high levels of GH, prolactin, and aldosterone, which support Th1 cell-mediated immunity, may facilitate the mounting of an effective adaptive immune response to a microbial challenge 54

Consequently, vascular dysfunction, including endothelial and blood-brain barrier (BBB) impairments, can lead to reduced blood flow, depriving neurons of the necessary substrates for ATP production (260)

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