La%20fisiologia%20del%20sonno

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La fisiologia del sonno

• Luigi Ferini-Strambi
• Centro di Medicina del Sonno
• Università Vita-Salute San Raffaele, Milano

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IL SONNO NEGLI ANIMALI (DURATA IN DI 24 ORE)
IN BASE ALLOSSERVAZIONE MUCCA
3 ELEFANTE 19 CAVALLO 29
GORILLA 70
IN BASE A REGISTRAZIONI EEG ASINO
13 RATTO 50 GATTO 60
CONIGLIO 60
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Organizzazione gerarchica delle strutture
responsabili del sonno
( L. Parmeggiani )

• Veglia NREM
  REM
• corteccia ipotalamo
  tronco
• ipotalamo tronco
  corteccia
• tronco corteccia
  ipotalamo

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PARAMETRI FISIOLOGICI PER LA DEFINIZIONE DEL SONNO
C M S D R
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IPNOGRAMMA
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Sleep Academic Award 12
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Dijk and Edgar, 1999, Lung Biology in Health
and Disease, vol.133

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VARIAZIONI DEL CICLO SONNO-VEGLIA
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Arousal
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Sleep
No sleep
Cortisol (µg/dl)
Thyrotropin (µU/ml)
acutesleepdeprivation
Prolactin (ng/ml)
Growth Hormone (µg/L)
Clock Time
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Cortisol rhythm
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Impact of sleep debt on metabolic and endocrine
functionSpiegel K, et al. The Lancet 1999,
35414351439.

• Intolleranza glucidica
• ?Clearance glucosio 40
• ?Risposta insulinica al glucosio 30
• Recupero sonno normalizza i valori

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Grasso è bello ???
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Self-reported Sleep and the Prevalence of Obesity
in the US
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25
20
8
15
Obesity prevalence
Sleep (hours)
7
10
6
5
Sleep (adult)
Obesity
0
5
1950
1960
1970
1980
1990
2000
2010
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DAYTIME LEPTIN AND GHRELIN LEVELS
3.5
3.0
LEPTIN (ng/ml)
2.5
AFTER 2 DAYS OF
2.0
10-H BEDTIMES
1.5
3.4
AFTER 2 DAYS OF
GHRELIN (ng/ml)
4-H BEDTIMES
2.8
2.2
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11
13
15
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19
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CLOCK TIME
p level change 9-21 leptin levels
(ng/ml) 2.6 0.5 2.1 0.4 0.041
-19 12-21 ghrelin levels (ng/ml) 2.6 0.2
3.3 0.2 0.038 24
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PRIVAZIONE DI SONNO

• Diminuisce lattività delle cellule natural
  killers nelluomo Moldofsky, 1989
• Impedisce nel topo messo a contatto con un virus
  influenzale di sviluppare memoria immunitaria
  Brown et al, 1989

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sleep loss impairs the human antibody response to
hepatisis A vaccination
total loss of sleep in the night following
vaccination impairs immune response 28 days later
Lange et al (2003) Psychosomatic Medicine 65
831-835
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response to influenza vaccination is impaired in
individuals with chronic partial sleep restriction
Sleep restriction to 4 hours/night, for 4 days
before and 2 days after vaccination, impairs
immune response to vaccination
Spiegel et al (2002) JAMA 288 1471-1472
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• Brain Structures That Did Not Show Decreased
  Metabolic Rate From Waking to Sleep States in
  Patients With Insomnia (A) and Brain Structures
  Where Relative Metabolism While Awake Was
  Significantly Higher in Healthy Subjects Than in
  Patients With Insomnia (B)

Nofzinger et al. Am J Psychiatry
20041612126-2128
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Increased Adenosine
SLEEP DEBT
Frontal Lobe dysfunctions
Reduced cortical cholinergic activity
Harrison Horne, 2000 Boonstra et al., 2007
One single night of sleep loss significantly
reduces prefrontal metabolic activity
PET studies
Thomas et al., J Sleep Res, 2007, 9 335-352
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J Clin Sleep Med, 2007
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