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Sleep Pathophysiology 

Sleep Pathophysiology
Chapter:
Sleep Pathophysiology
Author(s):

F. Presti Michael

DOI:
10.1093/med/9780190214883.003.0028
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date: 20 October 2019

Sleep is a natural, reversible, and periodic behavioral state characterized by perceptual inattention and decreased responsiveness to external stimuli. The processes governing sleep, sleep-wake transitions, and maintenance of wakefulness are mediated via complex physiologic mechanisms, the primary neurobiological substrates of which include the neocortex, basal forebrain, thalamus, hypothalamus, pontine tegmentum, and brainstem monoaminergic nuclei. Moreover, the integrity of brainstem autonomic respiratory control networks becomes critical in the maintenance of ventilation during sleep. Pathologic insults to these systems may result in a broad constellation of clinical deficits. This chapter reviews the normal stages of sleep, age-related changes in sleep composition, physiologic mechanisms mediating the generation and maintenance of sleep and wakeful states, and homeostatic and circadian control of sleep.

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