Enhancement of slow wave sleep: implications for insomnia.

摘要: Slow wave sleep (SWS) is defined as the sum of stage 3 and 4 characterized by high-voltage, synchronized electroencephalographic (EEG) waveforms, often measured slow activity (SWA). SWS has been widely hypothesized to be a time relatively heightened neurophysiologic restoration or recuperation.1,2 This viewpoint prompted number observations including: (1) enhanced SWA following deprivation in proportion duration prior wakefulness3; (2) reduced during nocturnal afternoon/evening naps4; (3) gradual decline across night sleep5; (4) increased nights fragmented sleep.6 Within two-process model regulation, SWS/SWA viewed reflecting Process S, homeostatic component.7 Other authors have proposed that represents ongoing cortical recovery from activities wakefulness.8 A agents found increase spent (Table 1). Interestingly, despite common observation SWS, these drugs several different mechanisms action. For example, tiagabine an inhibitor GAT-1, one four transporter proteins promote reuptake γ-aminobutyric acid (GABA) into presynaptic terminals surrounding glial cells. GAT-1 inhibition results synaptic levels GABA9 inhibitory activity. In contrast, gaboxadol extrasynaptic GABAA receptor agonist selective for δ receptors.10 When activated, α4-δ receptors produce tonic conductance, which thought result more stable pattern compared with phasic inhibition.11 no direct GABAergic effects yet also SWS. Examples include α2-δ calcium channel ligands (e.g., gabapentin pregabalin), serotonin (5HT)2A antagonists eplivanserin ritanserin), are active at multiple mirtazapine, trazodone, olanzapine). Table 1 Drugs Known Increase Wave Sleep The availability led research on behavioral phenomenologic correlates pharmacologic enhancement. article examines enhancement emphasis two studies12,13 designed determine whether increasing (with either gaboxadol) reduces established neurobehavioral physiologic deficits associated restriction. addition, potential role novel approach treatment insomnia considered.