Besset A
Service de neurologie B, CHU, Hôpital Gui-de-Chauliac, Montpellier.
Rev Prat. 1996 Dec 15;46(20):2411-5.
Sleep regulation calls for 3 processes: the first one is the homeostatic process increasing during wakefulness and decreasing during sleep, the second one is the circadian process depending on the circadian oscillator which controls temperature and alertness rhythms, and the third one is the ultradian process: it determines the NREM/REM periodicity. In the 2 process model of sleep regulation, the power density of the delta band (0.75-4.5 Hz) called slow wave activity (SWA) and obtained by spectral analysis, is supposed to reflect the variations of a homeostatic recovery process (process S) that increases in a saturating exponential way during wakefulness. Its decrease is expressed by the exponential decline of SWA during sleep. Process S interacts with the circadian process (process S) that determines the sleep timing. The 2 process model has been further modified to account for the semicircadian sleep propensity, although no satisfactory fit has been obtained with laboratory data. No impairment of NREM sleep homeostatic sleep regulation can be evidenced in narcoleptic patients who seem more sensitive to homeostatic regulation of sleep than normal subjects. On the other hand the circadian process appears to be weaker in narcoleptic patients than in normal subjects; this permits the occurrence of a strong ultradian component explaining diurnal sleep episodes.
第一个是稳态过程,在清醒时增加,睡眠时减少;第二个是昼夜节律过程,依赖于控制体温和警觉节律的昼夜节律振荡器;第三个是超日节律过程:它决定了非快速眼动睡眠/快速眼动睡眠的周期性。在睡眠调节的双过程模型中,通过频谱分析获得的称为慢波活动(SWA)的δ频段(0.75 - 4.5赫兹)的功率密度,被认为反映了一个稳态恢复过程(过程S)的变化,该过程在清醒时以饱和指数方式增加。其减少表现为睡眠期间SWA的指数下降。过程S与决定睡眠时间的昼夜节律过程(过程C)相互作用。双过程模型已进一步修改以解释半昼夜睡眠倾向,尽管尚未获得与实验室数据的满意拟合。发作性睡病患者中未发现非快速眼动睡眠稳态睡眠调节受损,他们似乎比正常受试者对睡眠的稳态调节更敏感。另一方面,发作性睡病患者的昼夜节律过程似乎比正常受试者弱;这使得能够出现一个强大的超日节律成分,解释日间睡眠发作。