Normal sleep: patterns and mechanisms.
In the last three decades, research in the sleep laboratory has decisively contributed to a much deeper knowledge of sleep physiologic and pathologic states. Parallel to clinical research related to sleep disorders, multifaceted basic research has greatly contributed to a better understanding of the mechanisms underlying sleep and wakefulness. This basic research in the realm of the neurosciences integrates data derived from the application of various methodologic approaches. Currently, the prevailing concepts about sleep mechanisms generally favor the idea of a dynamic interaction among systems rather than that of a unidimensional explanation for sleep generation. Examples of these integrative concepts in current sleep research are the revised model of reciprocal interaction for the control of REM sleep and the two-process model comprising the seemingly incompatible homeostatic and circadian sleep mechanisms. In sleep disorders medicine, the prevailing approach is also integrative: findings from the sleep laboratory are considered in conjunction with those from clinical experience in understanding the nature of sleep disorders. Applying this integrative model, physicians in sleep disorders medicine are able to manage patients with sleep disorders comprehensively. Based on an understanding of sleep physiology, clinicians can make the diagnosis of most sleep disorders in the office setting.
Bixler
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Sleep Research and Treatment Center, Pennsylvania State University, College of Medicine, Hershey.
Vela-Bueno
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D000293:Adolescent; D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology; D001921:Brain / Q000378:metabolism / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D002940:Circadian Rhythm; D006801:Humans; D007223:Infant; D008875:Middle Aged; D012890:Sleep / Q000502:physiology*; D012894:Sleep Stages / Q000502:physiology*