Sander Christian, Hensch Tilman, Wittekind Dirk Alexander, Böttger Daniel, Hegerl Ulrich
Neuropsychobiology. 2015;72(3-4):195-205. doi: 10.1159/000439384. Epub 2016 Feb 23.
During the last few decades, much knowledge has been gained about sleep being a heterogeneous condition with several distinct sleep stages that represent fundamentally different physiological states. The same applies for the wake state which also comprises distinct global functional states (called vigilance stages). However, various terms and concepts have been introduced describing different aspects of wakefulness, and accordingly several methods of assessment exist, e.g. sleep laboratory assessments (Multiple Sleep Latency Test, Maintenance of Wakefulness Test), questionnaires (Epworth Sleepiness Scale, Karolinska Sleepiness Scale), behavioural tasks (Psychomotor Vigilance Test) or electroencephalography (EEG)-based assessments (Alpha Attenuation Test, Karolinska Drowsiness Test). Furthermore, several theoretical concepts about the regulation of sleep and wakefulness have been put forward, and physiological correlates have been identified. Most relevant for healthy functioning is the regulation of brain arousal and the adaption of wakefulness to the environmental and situational needs so that the optimal balance between energy conservation and responsiveness can be obtained. Since one approach to the assessment of brain arousal regulation is the classification of EEG vigilance stages, a computer-based algorithm (Vigilance Algorithm Leipzig) has been introduced, allowing classification of EEG vigilance stages in EEG recordings under resting conditions. The time course of EEG vigilance stages in EEGs of 15-20 min duration allows estimation of the individual arousal regulation (hyperstable, adaptive, or unstable vigilance pattern). The vigilance model of affective disorders and attention-deficit/hyperactivity disorder links a disturbed arousal regulation to the pathogenesis of psychiatric disorders and accordingly helps to explain and possibly also predict treatment effects of pharmacological and non-pharmacological interventions for these conditions.
在过去几十年里，人们对睡眠有了很多了解，睡眠是一种异质性状态，有几个不同的睡眠阶段，代表着根本不同的生理状态。清醒状态也是如此，它同样包括不同的整体功能状态（称为警觉阶段）。然而，已经引入了各种术语和概念来描述清醒的不同方面，相应地也存在几种评估方法，例如睡眠实验室评估（多次睡眠潜伏期测试、清醒维持测试）、问卷调查（爱泼华嗜睡量表、卡罗林斯卡嗜睡量表）、行为任务（心理运动警觉性测试）或基于脑电图（EEG）的评估（阿尔法衰减测试、卡罗林斯卡嗜睡测试）。此外，还提出了一些关于睡眠和清醒调节的理论概念，并确定了其生理相关性。对健康功能最相关的是大脑觉醒的调节以及清醒状态对环境和情境需求的适应，以便在能量保存和反应能力之间获得最佳平衡。由于评估大脑觉醒调节的一种方法是对脑电图警觉阶段进行分类，因此引入了一种基于计算机的算法（莱比锡警觉算法），可以在静息状态下对脑电图记录中的脑电图警觉阶段进行分类。持续15 - 20分钟的脑电图中脑电图警觉阶段的时间进程可以估计个体的觉醒调节（超稳定、适应性或不稳定的警觉模式）。情感障碍和注意力缺陷/多动障碍的警觉模型将紊乱的觉醒调节与精神疾病的发病机制联系起来，因此有助于解释并可能预测针对这些病症的药物和非药物干预的治疗效果。
