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Sleep, the hypothalamic-pituitary-adrenal axis, and cytokines: multiple interactions and disturbances in sleep disorders.

Abstract
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 cortisol secretion, consistent with a disorder of central nervous system hyperarousal. Sleepiness and fatigue are very prevalent in the general population, and recent studies have demonstrated that the proinflammatory cytokines IL-6 and/or TNF-alpha are elevated in disorders associated with excessive daytime sleepiness, such as sleep apnea, narcolepsy, and idiopathic hypersomnia. Sleep deprivation leads to sleepiness and daytime hypersecretion of IL-6. Combined, these findings suggest that the HPA axis stimulates arousal, while IL-6 and TNF-alpha are possible mediators of excessive daytime sleepiness in humans.
AuthorsAlexandros N Vgontzas, George P Chrousos
JournalEndocrinology and metabolism clinics of North America (Endocrinol Metab Clin North Am) Vol. 31 Issue 1 Pg. 15-36 (Mar 2002) ISSN: 0889-8529 [Print] United States
PMID12055986 (Publication Type: Journal Article, Review)
Chemical References
  • Cytokines
  • Glucocorticoids
  • Adrenocorticotropic Hormone
  • Corticotropin-Releasing Hormone
Topics
  • Adrenal Glands (physiopathology)
  • Adrenocorticotropic Hormone (physiology)
  • Circadian Rhythm
  • Corticotropin-Releasing Hormone (physiology)
  • Cytokines (physiology)
  • Glucocorticoids (physiology)
  • Humans
  • Hypothalamus (physiopathology)
  • Pituitary Gland (physiopathology)
  • Sleep
  • Sleep Wake Disorders (physiopathology)
  • Stress, Physiological

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