Sleep homeostasis

These studies are consistent with the concept of POA control of homeostasis, but are not definitive. A definitive study demonstrating the necessity of the POA for homeostatic control of sleep using the lesion method would be difficult to interpret since baseline sleep would be greatly diminished. Instead, recent studies have examined the role of the POA in response to endogenous sleep factors thought to underlie sleep homeostasis. 

Borbely, A. A. Achermann, P. (2000). Sleep homeostasis and model of sleep... 

Frank, M. G., Stryker, M. P. Tecott, L. H. (2002). Sleep and sleep homeostasis in mice lacking the 5-HT2c receptor. Neuropsychopharmacology 27, 869-73. 

Orexin deficiency and abnormal regulation of non-REM sleep homeostasis... 

Landolt H.-P., Retey J. V., Tonz K. et al (2004). Caffeine attenuates waking and sleep electroencephalographic markers of sleep homeostasis in humans. Neuropsychopharmacology 29(10), 1933-9. 

Existing mathematical models predicting cognitive readiness/performance from sleep/wake history are based on the interaction of three factors. These factors are sleep homeostasis, circadian rhythm, and sleep inertia (12). Three-factor models successfully predict performance effects of acute, total sleep deprivation and... 

Ferrara M, DeGennaro F, Bertini M. Time-course of sleep inertia upon awakening from sleep with different sleep homeostasis conditions. Aviat Space Environ Med 2000 71(3) 225-229. 

Some researchers have documented significant positive correlations between slow-wave sleep during naps and reaction time performance improvements after normal nocturnal sleep (51) and sleep deprivation (52). Moreover, Lavie (53) documented preliminary laboratory findings that naps containing more of stages 3 and 4 sleep were associated with improved postnap sleepiness levels. Examining naps of 0, 15, 30, 60, and 120 min duration, Lumley et al. (31) also demonstrated that alertness increased as a function of duration of slow-wave sleep. Consistent with sleep homeostasis, Helmus et al. (48) also observed that a 2-hr nap opportunity was more recuperative than a 15-min nap opportunity, 2 hr after napping. 

In summary, while the theory of sleep homeostasis appears to adequately account for the effects associated with longer sleep episodes, particularly in reversing the effects of total and thus slow-wave sleep deprivation, its application to brief naps after mild sleep loss appears to be inadequate. Hence, further research is necessary to determine the mechanism by which brief naps exert their effects. Indeed, an understanding of the mechanism that improves behavioral efficiency after a brief nap is clearly an integral component of any comprehensive theory of sleep regulation. 

As for most behavioral therapies, the success of SRT is entirely dependent on the patient s compliance with the prescribed sleep window (7,22). Despite the apparent simplicity of this clinical procedure, therapist guidance is often essential to optimize compliance with the clinical recommendations (16). The first hurdle is making it clear to the patient what is expected and why. Indeed, the idea of curtailing even further the sleep of someone who presents with insomnia is somewhat paradoxical. For many patients, it is counterintuitive when sleep quality is unsatisfactory—from their vantage point, time in bed should be increased to obtain more satisfactory sleep. Thus, it is essential to explain the basic principles of sleep homeostasis and the rationale behind SRT, which should help patients better understand why time in bed should be restricted (27). The addition of sleep education is also useful for elderly individuals to explain the nature and extent of sleep changes associated with aging (16,18,22,25). 

Borbely AA, Achermann P. Sleep homeostasis and models of sleep regulation. In Kryger MH, Roth T, Dement WC, eds. Principles and Practice of Sleep Medicine, 3rd ed. Philadelphia Saunders, 2000 377-390. 

Trachsel L, Edgar DM, Seidel WF, Heller HC, Dement WC. Sleep homeostasis in suprachiasmatic nuclei-lesioned rats effects of sleep deprivation and triazolam administration. Brain Res 1992 589 253-261. 

Franken P, Tobler I, Borbely AA. Sleep homeostasis in the rat simulation of the time course of EEG slow-wave activity [published erratum appears in Neurosci Lett 1991 Nov 11 132(2) 279]. Neurosci Lett 1991 130 141-144. 

Borbely AA. From slow waves to sleep homeostasis new perspectives. Arch Ital Biol 2001 139 53-61. 

Landolt HP. Sleep homeostasis A role for adenosine in humans Biochem Pharmacol. 2008 75 2070-2079. 

Franken P, Dijk DJ (2009) Circadian clock genes and sleep homeostasis. Eur J Neurosci... 

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