Neuropharmacology of Sleep and Wakefulness

Watson, Christopher J.; Baghdoyan, Helen A.; Lydic, Ralph

doi:10.1016/j.jsmc.2010.08.003

Cited by 98 publications

(74 citation statements)

References 180 publications

(188 reference statements)

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“…The sleep-promoting agents are ACh (during REM), GABA, adenosine, melatonin, galanin, and glycine [25]. While many of these neurotransmitters and hormones contribute to sleep promotion, GABA is the primary sleep promoting neurotransmitter upon which most sleep medications act [26]. Barbiturates at low doses promote entry of chloride into GABA-activated channels [27].…”

Section: Neurotransmitters and Hormones In Sleepmentioning

confidence: 99%

“…Benzodiazepines also promote the entry of chloride into GABA-activated channels which subsequently relaxes the post-synaptic neuron [28]. With the exception of exogenous melatonin, a hormone analogue, medications target neurotransmitters, which either counteract a wake-promoting neurotransmitter or activate a sleep-promoting neurotransmitter [26].…”

Section: Neurotransmitters and Hormones In Sleepmentioning

confidence: 99%

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Insomnia: the Sleeping Giant of Pediatric Public Health

Badin

Haddad

Shatkin

2016

Curr Psychiatry Rep

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Insomnia among children and adolescents is ubiquitous and takes a great toll on youth and their families, impacting academic achievement, mood, social functioning, and a variety of developmental outcomes. Unfortunately, however, pediatric insomnia most often remains unidentified and untreated. When treatment is provided, it is most often in the form of medications, which are not FDA approved for that indication in children and adolescents. A comprehensive literature review was employed to establish the recommendations in this report. This article provides a review of sleep physiology and both current and recommended approaches to assessing and treating pediatric insomnia. Comprehensive assessment, accurate diagnosis, and evidence-based treatment of insomnia is imperative to the healthy development of children and adolescents. While clinicians often prescribe a variety of medications to treat pediatric insomnia, there is insufficient data to demonstrate efficacy and endorse their routine use. At this time, behavioral techniques, such as cognitive behavior therapy for insomnia and sleep hygiene education, should remain the first line of treatment. As a second-line consideration, melatonin, a dietary supplement, may be effective. Pediatric insomnia has an enormous impact on children, adolescents, and their families that requires adequate attention from clinicians and parents alike.

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Section: Neurotransmitters and Hormones In Sleepmentioning

confidence: 99%

Section: Neurotransmitters and Hormones In Sleepmentioning

confidence: 99%

Insomnia: the Sleeping Giant of Pediatric Public Health

Badin

Haddad

Shatkin

2016

Curr Psychiatry Rep

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“…The high expression of δ subunit-containing GABA A receptors in the thalamus may allow drugs such as gaboxadol to regulate the expression of the thalamocortical oscillations crucial to NREM sleep [108]. It should also be noted that at localized sites in the mesopontine brainstem, higher levels of GABA may actually promote wakefulness at the expense of REM and NREM sleep due to the complex circuits of inhibition and disinhibition involved in switching behavioral states [113].…”

Section: Part 2: Drugs For Diseases Of Sleep-clinical and Molecular Cmentioning

confidence: 99%

Drug-induced sleep: theoretical and practical considerations

Ellenbogen

Pace‐Schott

2011

Pflugers Arch - Eur J Physiol

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Faithful replication of normal sleep through medications--can it be achieved? Departure from normal sleep with the use of drugs--when is it desired? Answers to these questions depend on accurate understanding of sleep and on concrete criteria upon which to define it. Since these elements are evolving sciences, as yet incompletely known, one might take a nihilistic approach that we simply cannot judge whether we have successfully replicated sleep, since we do not fully grasp what sleep is or what it does. To address these potential obstacles, our article is written in two sections. The first addresses theoretical considerations for how medications might be seen in the larger framework of sleep. The purpose of this section is to inform readers about key issues in evaluating whether a drug has sufficient data to persuasively argue it is re-creating sleep. (We hope that researchers interested in conducting studies, or critical readers of the drug-study literature, might find this section particularly useful.) The second section of this article approaches exemplary, current concepts of pharmacologic manipulation of sleep, organized by disorders as articulated by the International Classification of Sleep Disorders (2005). This second section will combine practical knowledge of clinical sleep medicine, with emphasis on contemporary knowledge about molecular mechanisms that are felt to underlie some of these phenomena. We recognize that our collective knowledge about sleep will advance in the coming years. We hope that this article serves to facilitate that advance.

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“…Drugs used in sleep and wakefulness disorders manipulate complex interplay of neurons and neurotransmitters thus controlling sleep and arousal states at the desired time of the day. 6 Though, sleep medicine has made rapid strides in its field in the past few decades an ideal drug which does not extend its effect the next day and has a no potential for abuse is yet to be found. 6 …”

Section: Introductionmentioning

confidence: 99%

“…6 Though, sleep medicine has made rapid strides in its field in the past few decades an ideal drug which does not extend its effect the next day and has a no potential for abuse is yet to be found. 6 …”

Section: Introductionmentioning

confidence: 99%

Drugs affecting sleep and wakefulness: a review

Amar

2018

Int J Basic Clin Pharmacol

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It was in the second half of the twentieth century that Sleep Medicine was recognized as an immensely respected field of clinical research. As a result, past few decades have seen this field making some giant strides towards a better understanding of the neurochemical mechanisms that regulate the state of sleep and wakefulness. This involves a complex interplay of neuronal systems, neurotransmitters and some special nuclei located in the brain. Major wakefulness promoting nuclei being the orexinergic neurons in the lateral hypothalamic region and the tuberomammillary nucleus (TMN) while the sleep-promoting nucleus being ventrolateral preoptic nucleus (VLPO). Sleep-related complaints are one of the common complaints encountered by the physicians and the psychiatrists. As, long-standing sleep disturbances can have far-reaching implications on an individual’s physical, mental and social wellbeing, the importance of drugs affecting sleep and wakefulness could not be stressed upon anymore. Broadly, the sleep disorders are classified as insomnia, hypersomnia, and parasomnia and the presently available drugs work either by acting on the sleep-promoting GABAergic system like benzodiazepines, barbiturates etc. or by interacting with wakefulness promoting system like histaminergic system, 5- hydroxtryptaminergic system, orexinergic system etc. There are drugs which interact with other mechanisms which modulate arousal, like melatonin receptor agonists which promote sleep and adenosine receptor antagonists which promote wakefulness. This review article tries to have an overview of the available drugs for use in pathological states of sleep and wakefulness with a special emphasis on the commonly prescribed drugs and the recently approved one’s.

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Neuropharmacology of Sleep and Wakefulness

Cited by 98 publications

References 180 publications

Insomnia: the Sleeping Giant of Pediatric Public Health

Insomnia: the Sleeping Giant of Pediatric Public Health

Drug-induced sleep: theoretical and practical considerations

Drugs affecting sleep and wakefulness: a review

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