Abstract
The three vigilance states (wakefulness [W], slow wave sleep [SWS], rapid eye movement sleep [REMS]) are controlled by distinct, but interconnected, networks of neurons. The sleep/arousal network consists of separate systems of W-promoting and SWS-promoting neurons, located in nuclei in the basal forebrain, diencephalon and brainstem. Each neuronal system operates via a distinct neurotransmitter, providing its unique “neurochemical signature”. W-promoting neurons are active during W and quiescent during SWS, whereas SWS-promoting neurons are active during SWS and cease to fire during W. The level of arousal at any one time reflects the intricate balance between W-promoting and SWS-promoting systems. W is the result of cortical activation by W-promoting neurons; sleep ensues when SWS-promoting neurons switch off the W-promoting systems. REMS is regulated by a network of REMS-promoting and REMS-inhibiting neurons located in the brainstem and hypothalamus. A third network is responsible for the regulation of the circadian rhythmicity of the wakefulness/sleep cycle. The neurochemical signatures of W-promoting and SWS-promoting neurons make it possible to develop drugs that, by targeting specific neuroreceptors and synaptic mechanisms, have predictable effects on sleep and arousal. Arousal-modifying drugs act by tipping the balance between W-promoting and SWS-promoting neuronal activity. Thus a sedative drug, useful for the treatment of insomnia, may act by activating a SWS-promoting system (e.g. benzodiazepines, melatonin receptor agonists) or inhibiting a W-promoting system (e.g. H1-antihistamines, orexin receptor antagonists). Conversely, an alerting drug, useful for the treatment of excessive daytime sleepiness, may inhibit a SWS-promoting system or activate a W-promoting system (e.g. psychostimulants, H3 histamine receptor antagonists).
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Abbreviations
- BF:
-
Basal forebrain
- DMH:
-
Dorsomedial hypothalamus
- DR:
-
Dorsal raphe nucleus
- LC:
-
Locus coeruleus
- LDT:
-
Laterodorsal tegmental nucleus
- LGN:
-
Lateral geniculate nucleus
- LH:
-
Lateral hypothalamic area
- MCH:
-
Melanin concentrating hormone
- PBN:
-
Parabrachial nucleus
- PC:
-
Precoeruleus nucleus
- PF:
-
Perifornical area
- PPT:
-
Pedunculopontine tegmental nucleus
- PVN:
-
Paraventricular nucleus
- SCN:
-
Suprachiasmatic nucleus
- SLD:
-
Sublaterodorsal nucleus
- SPZ:
-
Subparaventricular zone
- Th:
-
Thalamus
- TMN:
-
Tuberomamillary nucleus
- TPR:
-
Tegmentopontine reticular nucleus
- vGC:
-
Ventral gigantocellular nucleus
- vlPAG:
-
Ventrolateral periaquductal grey (matter)
- VLPO:
-
Ventrolateral preopic nucleus
- VPAG:
-
Ventral periaquductal grey (matter)
- VTA:
-
Ventral tegmental area
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I am grateful to Rob Langley for drawing the figures.
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Szabadi, E. (2015). Neuronal Networks Regulating Sleep and Arousal: Effect of Drugs. In: Guglietta, A. (eds) Drug Treatment of Sleep Disorders. Milestones in Drug Therapy. Springer, Cham. https://doi.org/10.1007/978-3-319-11514-6_2
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