Sleep Disorders: Diagnosis, Management and Treatment : a Handbook for Clinicians

By Peretz Lavie; Giora Pillar et al. | Go to book overview

chapter 2

Systemic function during normal sleep

The sleep-wake cycle is an output of the central nervous system, but may affect almost every other somatic system. In some phenomena, it is difficult to distinguish between sleep effects and circadian effects (i.e. nocturnal), because in the normal population, on whom most of the studies took place, sleep occurs during the night period. Some studies have addressed this issue, and reported direct effects of sleep or circadian timing on the various physiological systems. In this chapter we briefly review these systems.


The neuromuscular system

As stated previously, during sleep the central nervous system (CNS) remains active and in fact determines the behavioural state in an active process. It is beyond the scope of this book to go into details of the function of the various regions of the brain in the different sleep stages. Briefly, it is generally believed that the cerebral cortex does not possess an intrinsic mechanism for its own activation, and thus the maintenance of wakefulness requires ascending excitatory input from the subcortical structures and brain stem.

The major regions responsible for wakefulness include the reticular formation (projections from various regions), basal forebrain (cholinergic), locus coeruleus (noradrenergic), dorsal raphe (serotoninergic) and

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Sleep Disorders: Diagnosis, Management and Treatment : a Handbook for Clinicians
Table of contents

Table of contents

  • Title Page iii
  • Contents v
  • Preface vii
  • Chapter 1 - History of Sleep Medicine 1
  • Chapter 2 - Systemic Function During Normal Sleep 19
  • Chapter 3 - Hypersomnia: an Introduction 41
  • Chapter 4 - Sleep Apnoea Syndrome 47
  • Chapter 5 - Periodic Limb Movement Disorder 89
  • Chapter 6 - Primary and Other Forms of Hypersomnia 97
  • Chapter 7 - Hypersomnia: Summary and Patient Approach 109
  • Chapter 8 - Insomnia 115
  • Chapter 9 - Parasomnias 145
  • Appendix 167
  • Index 177
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