The Neurobiology of Sleep and Wakefulness


Schwartz MD, Kilduff TS (2015). The Neurobiology of Sleep and Wakefulness. Psychiatr Clin North America 38(4):615-44.


Cortical electroencephalographic activity arises from corticothalamocortical interactions, modulated by wake-promoting monoaminergic and cholinergic input. These wake-promoting systems are regulated by hypothalamic hypocretin/orexins, while GABAergic sleep-promoting nuclei are found in the preoptic area, brainstem and lateral hypothalamus. Although pontine acetylcholine is critical for REM sleep, hypothalamic melanin-concentrating hormone/GABAergic cells may “gate” REM sleep. Daily sleep-wake rhythms arise from interactions between a hypothalamic circadian pacemaker and a sleep homeostat whose anatomical locus has yet to be conclusively defined. Control of sleep and wakefulness involves multiple systems, each of which presents vulnerability to sleep/wake dysfunction that may predispose to physical and/or neuropsychiatric disorders.

Keywords: EEG, synchronization, homeostasis, slow wave activity, NREM sleep, REM sleep, neurotransmitter, hypocretin, orexin, adenosine

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