Journal
PSYCHIATRIC CLINICS OF NORTH AMERICA
Volume 38, Issue 4, Pages 615-+Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.psc.2015.07.002
Keywords
EEG; Synchronization; Homeostasis; Slow wave activity; NREM sleep; REM sleep; Neurotransmitter; Hypocretin
Categories
Funding
- NIH [R01 HL059658, R01 NS077408, R21 NS087550, R01 NS082876, R21 NS083639, R21 NS085757]
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Cortical electroencephalographic activity arises from corticothalamocortical interactions, modulated by wake-promoting monoaminergic and cholinergic input. These wake-promoting systems are regulated by hypothalamic hypocretin/orexins, while GABAergic sleep-promoting nuclei are found in the preoptic area, brainstem and lateral hypothalamus. Although pontine acetylcholine is critical for REM sleep, hypothalamic melanin-concentrating hormone/GABAergic cells may gate REM sleep. Daily sleep-wake rhythms arise from interactions between a hypothalamic circadian pacemaker and a sleep homeostat whose anatomical locus has yet to be conclusively defined. Control of sleep and wakefulness involves multiple systems, each of which presents vulnerability to sleep/wake dysfunction that may predispose to physical and/or neuropsychiatric disorders.
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