Sleep disorders have emerged as a critical global health issue, highlighting the urgent need for effective and widely accessible intervention technologies. Non-invasive brain stimulation has garnered attention as it enables direct or indirect modulation of neural activity, thereby promoting sleep enhancement in a safe and unobtrusive manner. This class of approaches is collectively referred to as sleep modulation. To date, the majority of sleep modulation research relies on open-loop paradigms with empirically determined parameters, while achieving individual adaptation and modulation accuracy remains a distant objective. The paradigm-specific constraints inherent to open-loop designs represent a major obstacle to clinical translation and large-scale deployment in home environments. In this paper, we delineate fundamental paradigms of sleep modulation, critically examine the intrinsic limitations of open-loop approaches, and formally conceptualize sleep closed-loop modulation. We further provide a comprehensive synthesis of prior studies involving five commonly employed modulation techniques, evaluating their potential integration within a closed-loop framework. Finally, we identify three primary challenges in constructing an effective sleep closed-loop modulation system: sensor solution selection, monitoring model design, and modulation strategy design, while also proposing potential solutions. Collectively, this work aims to advance the paradigm shift of sleep modulation from open-loop toward closed-loop systems.

翻译：睡眠障碍已成为全球性的重大健康问题，凸显了对有效且广泛可及的干预技术的迫切需求。非侵入性脑刺激技术因其能够直接或间接调节神经活动，从而以安全、无干扰的方式促进睡眠改善而受到关注。这类方法被统称为睡眠调控。迄今为止，大多数睡眠调控研究依赖于基于经验参数确定的开环范式，而实现个体适应性与调控精度仍是一个遥远的目标。开环设计固有的范式特异性限制，是临床转化及家庭环境大规模部署的主要障碍。本文系统阐述了睡眠调控的基本范式，批判性分析了开环方法的内在局限性，并正式提出了睡眠闭环调控的概念框架。我们进一步综合评述了五种常用调控技术的既往研究，评估其在闭环框架内的整合潜力。最后，我们指出了构建有效睡眠闭环调控系统的三大核心挑战：传感器方案选择、监测模型设计与调控策略设计，并提出了潜在的解决方案。本研究旨在共同推动睡眠调控范式从开环系统向闭环系统的转变。