Department of Integrative Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
Sleep is an essential component in health and the quality of life of individual. Normally, sleep pattern changes with stress system. Stress is known to be a common cause of short-term insomnia and insomniacs often complain that stress induces sleep problems. Studies suggest that sleep deprivation may activate the hypothalamic-pituitary-adrenal (HPA) axis, one of the main neuroendocrine stress systems. In addition, sleep and wakefulness is regulated by the aminergic, acetylcholinergic brainstem and hypothalamic systems. Classically, activation of the HPA and/or the sympathetic nervous systems results in waking. In human beings or animals, these hormones, corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH), cortisol or corticosterone, noradrenaline, and adrenaline, are associated with attention, vigilance and arousal. An increased awareness of the close interaction between sleep and stress systems is also emerging. The hypothalamus is now recognized as a key center for sleep regulation, with hypothalalmic neurontransmitter systems providing the framework for therapeutic advances. An updated understanding of these systems should allow clinicians and researchers to better understand the effects of drugs, injury and neurologic disease on sleep and wakefulness. (Korean J Str Res 2009;17:209∼217)