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儿童长期睡眠障碍:神经元缺失的一个原因。

Long-term sleep disturbances in children: a cause of neuronal loss.

机构信息

Pediatric Neurology and Developmental Pediatrics, University of British Columbia, BC, Canada.

出版信息

Eur J Paediatr Neurol. 2010 Sep;14(5):380-90. doi: 10.1016/j.ejpn.2010.05.001. Epub 2010 Jun 2.

Abstract

Short-term sleep loss is known to cause temporary difficulties in cognition, behaviour and health but the effects of persistent sleep deprivation on brain development have received little or no attention. Yet, severe sleep disorders that last for years are common in children especially when they have neurodevelopmental disabilities. There is increasing evidence that chronic sleep loss can lead to neuronal and cognitive loss in children although this is generally unrecognized by the medical profession and the public. Without the restorative functions of sleep due to total sleep deprivation, death is inevitable within a few weeks. Chronic sleep disturbances at any age deprive children of healthy environmental exposure which is a prerequisite for cognitive growth more so during critical developmental periods. Sleep loss adversely effects pineal melatonin production which causes disturbance of circadian physiology of cells, organs, neurochemicals, neuroprotective and other metabolic functions. Through various mechanisms sleep loss causes widespread deterioration of neuronal functions, memory and learning, gene expression, neurogenesis and numerous other changes which cause decline in cognition, behaviour and health. When these changes are long-standing, excessive cellular stress develops which may result in widespread neuronal loss. In this review, for the first time, recent research advances obtained from various fields of sleep medicine are integrated in order to show that untreated chronic sleep disorders may lead to impaired brain development, neuronal damage and permanent loss of developmental potentials. Further research is urgently needed because these findings have major implications for the treatment of sleep disorders.

摘要

短期睡眠不足会导致认知、行为和健康方面的暂时困难,但持续睡眠不足对大脑发育的影响却很少受到关注或根本没有受到关注。然而,在儿童中,尤其是在有神经发育障碍的儿童中,持续数年的严重睡眠障碍很常见。越来越多的证据表明,慢性睡眠不足会导致儿童的神经元和认知能力丧失,尽管这通常未被医学界和公众所认识。由于完全睡眠剥夺,没有睡眠的恢复功能,几周内就会死亡。由于总睡眠剥夺,儿童无法获得健康的环境暴露,而这是认知成长的前提条件,在关键发育时期更是如此。任何年龄段的慢性睡眠障碍都会使儿童失去健康的环境暴露,这是认知成长的前提条件,在关键发育时期更是如此。睡眠不足会导致松果腺褪黑素的产生受到干扰,从而扰乱细胞、器官、神经化学物质、神经保护和其他代谢功能的昼夜生理节律。睡眠不足通过各种机制导致神经元功能、记忆和学习、基因表达、神经发生和许多其他变化的广泛恶化,从而导致认知、行为和健康的下降。当这些变化持续存在时,会产生过度的细胞应激,从而可能导致广泛的神经元丧失。在这篇综述中,首次整合了来自睡眠医学各个领域的最新研究进展,以表明未经治疗的慢性睡眠障碍可能导致大脑发育受损、神经元损伤和发育潜力的永久丧失。由于这些发现对睡眠障碍的治疗具有重大意义,因此迫切需要进一步研究。

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