Overview of Sleep: The Neurologic Processes of the Sleep-Wake Cycle




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Sleep problems are common in adults and should be treated to improve overall health and safety. To choose the best treatment for patients with sleep problems, clinicians should understand the sleep-wake cycle and the stages of rapid eye movement and non-rapid eye movement sleep as well as the neurologic pathways of sleep and wake systems. The sleep- and wake-promoting systems are mutually inhibitory, with the predominantly active system determining if a person is awake or asleep. The orexin system also plays an important role in the stabilization of the sleep-wake cycle.

From the Division of Sleep Medicine, Department of Neurology, Harvard Medical School, Boston, Massachusetts.

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J Clin Psychiatry 2015;76(5):e13