Emily Goldberg M.S., CCC-SLP
University of Pittsburgh, Department of Communication Science & Disorders
Veterans Administration Pittsburgh Healthcare System
Center for Neural Basis of Cognition, Carnegie Mellon University & University of Pittsburgh
University of Pittsburgh, Center for Sleep and Circadian Science
Reframing Language Rehabilitation as a Sleep-Dependent Learning Process to Enhance Healthy Aging
Aphasia is a chronic language disorder that disproportionately affects older adults following stroke, with profound consequences for communication, independence, and quality of life. Although behavioral language therapy is the clinical standard for managing aphasia, treatment outcomes vary widely, and mechanisms supporting successful language re-learning remain poorly understood. Because rehabilitation depends on learning and memory processes, identifying biological factors that support or constrain learning is critical for improving aphasia outcomes.
I present a program of research that reframes aphasia rehabilitation as a sleep-dependent learning process at the intersection of communication science, cognitive neuroscience, and healthy aging. Sleep disturbance is common after stroke and changes systematically with age, yet sleep has been overlooked as a contributor to aphasia recovery. Drawing on behavioral, neuroimaging, and sleep data from individuals with chronic post-stroke aphasia, I introduce a neurobiological model proposing complementary hippocampal and neocortical routes to language re-learning. I then describe ongoing work testing this model by examining associations between sleep quality and treatment-driven changes in language function and neural organization. Finally, I outline future directions that integrate sleep physiology into aphasia rehabilitation and extend these principles to healthy aging, positioning sleep as a modifiable mechanism for promoting learning and plasticity across the lifespan.