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Neurological diseases and their effects on the sleep–wake cycle 

Neurological diseases and their effects on the sleep–wake cycle
Neurological diseases and their effects on the sleep–wake cycle

Paul J. Reading

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date: 27 November 2020

This chapter addresses current neurobiological knowledge of how wake- and sleep-promoting systems interact to produce the daily circadian rhythm of wake and sleep and how this may be adversely affected by a variety of neurological diseases. The crucial importance of sleep quality for optimal brain function is stressed and the potential hazards of prolonged wakefulness highlighted. Insomnia relating to either sleep onset or maintenance is common and increases with normal aging. Many neurodegenerative diseases such as Alzheimer disease appear to enhance the effects of aging on the sleep–wake cycle, with increased fragmentation and reduced deep sleep. Focal pathology in the thalamus or sometimes the hypothalamus may produce striking insomnia, as may several autoimmune encephalitides. Hypersomnia is most often secondary to poor-quality nocturnal sleep, but may also relate to discrete hypothalamic pathology or traumatic head injury. The effects of epilepsy and its treatment on sleep can be significant and are discussed.

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