Kumar Velayudhan Mohan
Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala State, India.
Indian J Chest Dis Allied Sci. 2008 Jan-Mar;50(1):129-35.
Sleep is a complex neurological state, with its primary function of providing rest and restoring the body's energy levels. The importance of sleep could be seen from the fact that people spend about one-third of their lifespan in sleep. Normal human sleep is divided into non-rapid eye movement (NREM) and rapid eye movement (REM) sleep, and the alteration between NREM and REM occurs about 4-5 times during a night of normal sleep. Human NREM sleep could be classified into four stages, namely, stage I, II, III and IV, representing successively deeper stages of sleep. Sleep is an active rhythmic neural process produced by several brain areas, of which the preoptic and other basal forebrain areas play a major role in the generation of NREM sleep. Interaction of the pedenculo-pontine and lateral dorsal tegmental areas with the dorsal raphae nucleus and locus coeruleus, is important for REM sleep generation. Suprachiasmatic nucleus of the hypothalamus and the pineal gland ensure that sleep and wakefulness follow a circadian periodicity of nearly 24 hours. Alterations in the quality, quantity and pattern of sleep result in sleep disorders. Persistent and repeated interruption of sleep affects the health of an individual. Undiagnosed and untreated wake/sleep complaints cause not only misery to the sufferer, but it also has socio-economic consequences. Sleep disorders cover a wide spectrum of diseases. Though there are more than 100 identified sleep/wake disorders, most sleep complaints can be categorised into five, namely, hypersomnia, insomnia, circadian rhythm disorders, parasomnias, and sleep disorders associated with mental, neurological, and other medical disorders. Researches during the last 50 years, and the advances made in clinical sleep medicine, have lead to more effective treatments for the myriad human sleep disorders. It is not possible to assign a specific reason for many of the sleep disorders, but some aspects of sleep and wakefulness are genetically influenced. But, most commonly, sleepiness during waking hours, results from volitional or forced sleep deprivation during previous nights, due to social, economic and environmental reasons. So, public awareness about sleep disorders should be an essential part of any programme aimed at global management of sleep disorders.
睡眠是一种复杂的神经状态，其主要功能是提供休息并恢复身体的能量水平。从人们一生中约三分之一的时间用于睡眠这一事实，就能看出睡眠的重要性。正常的人类睡眠分为非快速眼动（NREM）睡眠和快速眼动（REM）睡眠，在正常睡眠的一晚中，NREM和REM之间的交替会发生约4至5次。人类的NREM睡眠可分为四个阶段，即第一阶段、第二阶段、第三阶段和第四阶段，代表着睡眠依次加深的阶段。睡眠是由几个脑区产生的一种活跃的节律性神经过程，其中视前区和其他基底前脑区在NREM睡眠的产生中起主要作用。脑桥脚被盖区和外侧背盖区与中缝背核和蓝斑之间的相互作用，对REM睡眠的产生很重要。下丘脑的视交叉上核和松果体确保睡眠和清醒遵循近24小时的昼夜节律。睡眠的质量、数量和模式的改变会导致睡眠障碍。持续且反复的睡眠中断会影响个体的健康。未被诊断和治疗的清醒/睡眠问题不仅会给患者带来痛苦，还会产生社会经济后果。睡眠障碍涵盖了广泛的疾病。尽管已确定的睡眠/清醒障碍有100多种，但大多数睡眠问题可分为五类，即嗜睡症、失眠症、昼夜节律障碍、异态睡眠，以及与精神、神经和其他医学疾病相关的睡眠障碍。过去50年的研究以及临床睡眠医学取得的进展，已带来了针对众多人类睡眠障碍更有效的治疗方法。许多睡眠障碍无法归因于某个特定原因，但睡眠和清醒的某些方面受遗传影响。不过，最常见的是，清醒时的困倦是由于前一晚出于社会、经济和环境原因的自愿或被迫睡眠剥夺所致。因此，公众对睡眠障碍的认识应成为任何旨在全球管理睡眠障碍的计划的重要组成部分。
