卢静成 杨立新 赵花

摘要睡眠对于人类的一生来说，是必不可少的组成部位，人生有三分之一的时间处于睡眠状态，许多疾病也跟睡眠有关。但是睡眠觉醒到底是如何控制的，至今尚不明确。但可以肯定的是睡眠觉醒系统是由多种神经肽递质参与的，其中可分为促睡眠类和促觉醒类。二者共同合作，来维持睡眠觉醒系统。目前发现觉醒在阻塞性睡眠呼吸暂停（OSA）发病及预后过程中的作用越来越受到重视，而OSA相关觉醒的具体产生机制尚不明确。本综述重点概括了可能参与OSA相关觉醒的神经递质。

关键词睡眠;觉醒;阻塞性睡眠呼吸暂停;5羟色胺;神经肽S;神经肽Y;γ氨基丁酸;食欲素;儿茶酚胺;黑色素浓缩激素;乙酰胆碱

Possible Role of Neurotransmitters in OSARelated Arousal

LU Jingcheng1，YANG Lixin2，ZHAO Hua1，ZHOU Ning2

（1 Bengbu Medical College，Bengbu 233000，China; 2 Huainan First People′s Hospital，Huainan 232000，China）

AbstractSleep is an indispensable part of human lifeOne third of human life is spent sleepingMany diseases are also related to sleepBut how sleeparousal is controlled remains unclearBut it is certain that the sleeparousal system is participated by a variety of neuropeptide transmitters，which can be divided into sleeppromoting and arousalpromoting categoriesThey work together to maintain the sleeparousal systemIt has been found that the role of arousal in the pathogenesis and prognosis of OSA has been paid more and more attention，but the specific mechanism of OSArelated arousal is still unclearThis review focuses on the possible neurotransmitters involved in OSArelated arousal.

KeywordsSleep; Arousal; Obstructive sleep apnea; 5HT; Neuropeptide S; Neuropeptide Y; γaminobutyric acid; Orexin; Catecholamine; Melanin concentrate hormone

中圖分类号：R33863文献标识码：Adoi：10.3969/j.issn.2095-7130.2020.06.083

睡眠觉醒系统由多种神经肽递质参与，其中可分为促睡眠类和促觉醒类。二者共同合作，来维持睡眠觉醒系统。目前发现觉醒在阻塞性睡眠呼吸暂停（Obstructive Sleep Apnea，OSA）发病及预后过程中的作用越来越受到重视，而OSA相关觉醒具体产生机制尚不明确，本文在查阅大量有关睡眠觉醒神经调节机制的文献后进行详细综述，现将结果报道如下。

1分类综述

115羟色胺5羟色胺（5Hydroxytyptamine，5HT）又名血清素，主要通过其相应的受体介导发挥作用。关于5羟色胺神经元调节睡眠觉醒的作用，有研究发现大鼠在消融中枢5HT神经元后，总快速眼动睡眠期（Rapid Eye Movement，REM）时间减短，这可能是非快速眼动睡眠期（NonRapid Eye Movement，NREM）到REM的过渡减少347%有关，并且与对照组相比觉醒反应减弱[1]。……