Dayton Department of Veterans Affairs Medical Center, Wright State University, Dayton, OH 45428, USA.
Sleep Med Rev. 2010 Feb;14(1):9-15. doi: 10.1016/j.smrv.2009.05.002. Epub 2009 Jul 28.
In the past few years it has become increasingly clear that insomnia is a chronic disease that interacts with many other medical conditions. As our ability to examine complex physiological activity during sleep has increased, additional evidence continues to suggest that insomnia is associated with inappropriate physiological arousal. It is now known that patients with primary insomnia have increased high-frequency EEG activation, abnormal hormone secretion, increased whole body and brain metabolic activation, and elevated heart rate and sympathetic nervous system activation during sleep. This activation can be measured throughout the day and night and is chronic. Other research suggests that insomnia, probably based upon the associated chronic physiologic arousal, is associated with increased risk for medical disorders such as depression, hypertension, or cardiac disease. An animal model that has used odor stress to produce poor sleep in rats has identified specific activated brain sites similar to those found in human brain metabolic studies to suggest that insomnia is a state in which sleep and arousal systems are both simultaneously active. The animal studies have also shown that the inappropriate arousal can be blocked by lesions in the limbic and arousal systems. It is hoped that these findings can be extended to identify new compounds that improve insomnia by acting at these sites of abnormal brain activation.
在过去的几年中，越来越明显的是，失眠是一种慢性病，与许多其他医疗状况相互作用。随着我们在睡眠期间检查复杂生理活动的能力的提高，更多的证据继续表明，失眠与不适当的生理唤醒有关。现在已知原发性失眠症患者的高频 EEG 激活增加，激素分泌异常，全身和大脑代谢激活增加，以及睡眠期间心率和交感神经系统激活增加。这种激活可以在白天和晚上测量，并且是慢性的。其他研究表明，失眠可能是由于相关的慢性生理唤醒，与增加患抑郁症、高血压或心脏病等疾病的风险有关。一种使用气味应激在大鼠中产生睡眠不佳的动物模型已经确定了与人类大脑代谢研究中发现的相似的特定激活脑区，这表明失眠是一种睡眠和唤醒系统同时活跃的状态。动物研究还表明，通过在边缘和唤醒系统中产生病变，可以阻止不适当的唤醒。希望这些发现可以扩展到识别通过作用于这些异常大脑激活部位来改善失眠的新化合物。
