Current Pharmaceutical Design - Volume 14, Issue 32, 2008

On average we spend one third of our lives asleep, and we have little idea why. Similarly, despite the high prevalence of sleep disorders and their negative impact on waking functions and life quality, which significantly contribute to healthcare costs, most basic pathophysiological mechanisms are still unknown. Knowledge accumulated in recent years about the identification of susceptibility genetic determinants, about biochem Read More

The contribution of genes, environment and gene-environment interactions to sleep disorders is increasingly recognized. Well-documented familial and twin sleep disorder studies suggest an important influence of genetic factors. However, only few sleep disorders have an established genetic basis including four rare diseases that may result from a single gene mutation: fatal familial insomnia, familial advanced sleep-phase sy Read More

To better understand the neurobiology of sleep disorders, detailed understanding of circadian and homeostatic sleep-wake regulation in healthy volunteers is mandatory. Sleep physiology and the repercussions of experimentallyinduced sleep deprivation on sleep and waking electroencephalogram (EEG), vigilance and subjective state are highly variable, even in healthy individuals. Accumulating evidence sugg Read More

Interleukin-1 beta (IL1) and tumor necrosis factor alpha (TNF) promote non-rapid eye movement sleep under physiological and inflammatory conditions. Additional cytokines are also likely involved but evidence is insufficient to conclude that they are sleep regulatory substances. Many of the symptoms induced by sleep loss, e.g. sleepiness, fatigue, poor cognition, enhanced sensitivity to pain, can be elicited by injection of Read More

Functional neuroimaging methods provide a means to understand brain function in patients with sleep disorders. This paper summarizes functional neuroimaging findings in sleep disorders patients, and studies addressing the pharmacology of sleep and sleep disorders. Areas in which functional neuroimaging methods may be helpful in sleep medicine, and in which future development is advised, include: 1) clarification of pathop Read More

This review presents sleep disturbances and their underlying pathophysiology in three categories of neurodegenerative disorders namely tauopathies, synucleinopathies, and Huntington's disease (HD) and prion-related diseases. Sleep abnormalities are a major and early feature of neurodegenerative disorders, especially for synucleinopathies, HD and prion-related diseases, in which the sleep-related brainstem regi Read More

In the last two decades quantitative electroencephalogram (EEG) analysis has been widely used to investigate the neurophysiological characteristics of insomnia. These studies provided evidence in support of the hypothesis that primary insomnia is associated with hyperarousal of central nervous system and altered sleep homeostasis. However, we have here underlined that these results have intrinsic methodologi Read More

In this review, the context and evidence base for intermittent and long term dosing with hypnotics is critically evaluated. The context provided includes addressing two questions: “why has long term or maintenance therapy not been a standard for practice for the treatment of chronic insomnia?”; and “why is intermittent dosing thought to represent a potential solution for the problem of chronic insomnia?”. The data fr Read More

Obstructive sleep apnea syndrome (OSA) is a highly prevalent breathing disorder in sleep affecting at least 2- 4% of the adult population. A large number of studies have demonstrated that OSA is an independent risk factor of cardiovascular morbidity and mortality. Sleep apnea was shown to be associated with hypertension, ischemic heart disease, stroke, pulmonary hypertension, cardiac arrhythmia, and cardiovascular morta Read More

New insights into the physiopathological correlates of arousal and sleep fragmentation have recently been gained through experimental and clinical studies in healthy individuals and in patients with sleep disorders. The development of new analyses of autonomic system during sleep, has enriched the knowledge of sleep fragmentation derived from electroencephalographic analysis and has made possible the characterizat Read More