SLEEP DISORDERS

A Pathophysiological Model

byAllan Hobson

Harvard Medical School

Normal Sleep is a Product of

Dynamic Neuronal Interaction

Changes in the Balance of Neuronal Interaction Causes Abnormal Sleep

BRAIN STEMas a set of Coupled OscillatorsCircadian-HypothalamusUltradian-PonsRespiratory-Medulla

MEDIATING FACTORSSet point Changes Timing Errors

NARCOLEPSYGelineau’s Tetrad

Sleep AttacksCataplexyHypnogogic HallucinationHypnopompic Hallucination

SLEEP APNEA SYNDROMESCentral Factors

Peripheral FactorsInteraction

REM SLEEP BEHAVIOR DISORDER

Older MenAct Out DreamsLoss of Muscle InhibitionHarbinger of Parkinson’s Disease