Review articleSleep, the hypothalamic–pituitary–adrenal axis, and cytokines: multiple interactions and disturbances in sleep disorders
Section snippets
Sleep disorders
Sleep disorders are common in the general population and are associated with significant medical, psychologic, and social disturbances [3], [42]. Insomnia, the most common sleep disorder, most often reflects psychologic disturbances [11], [27], [37]. Excessive daytime sleepiness is the predominant complaint of most patients evaluated in sleep disorders clinics and often reflects organic dysfunction. Sleep apnea, narcolepsy, and idiopathic hypersomnia are the most common disorders associated
Sleep and the stress system
In mammalian organisms, including humans, the stress system consists of components of the central nervous system, including the corticotropin-releasing hormone (CRH) neurons of the hypothalamic paraventricular nucleus and several, mostly noradrenergic nuclei, of the brain stem and their respective peripheral limbs, the hypothalamic–pituitary–adrenal (HPA) axis and the peripheral autonomic system, whose main function is to maintain homeostasis, in resting and stress states [12], [13], [15].
Sleep disorders and the HPA axis
Although sleep disorders and/or disturbances with their various physical and mental effects on the individual should be expected to affect the stress system, information regarding the effects of sleep disorders and/or disturbances on this system is very limited.
Sleep and cytokines
Feelings of fatigue and sleepiness are common symptoms associated with infectious diseases and many other physical and mental pathologic conditions. For millennia, physicians have advised their patients to sleep during the course of an illness. It is only within the past 15 to 20 years, however, that there has been a systematic study on changes in sleep that occur with infection or following microbial product-induced cytokine production.
The first reports of the effects of interleukin-1 (IL-1)
Summary
Sleep is an important component of mammalian homeostasis, vital for survival. Sleep disorders are common in the general population and are associated with significant medical, psychologic, and social disturbances. Sleep, in particular deep sleep, has an inhibitory influence on the HPA axis, whereas activation of the HPA axis or administration of glucocorticoids can lead to arousal and sleeplessness. Insomnia, the most common sleep disorder, is associated with a 24-hour increase of ACTH and
Uncited references
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