Luppi · Handbook of clinical neurology 2019 · narrative review · n=?

Sleep-wake physiology.

Cited 61 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review chapter summarizing neurobiological mechanisms without systematic methodology or primary human data

PubMed 31277860 · doi:10.1016/B978-0-444-64032-1.00023-0 · record verified 2026-08-30

What was done

This book chapter provides a narrative review summarizing hypotheses and evidence regarding the neurobiological circuits that control transitions between wakefulness, non-rapid eye movement (NREM or slow-wave sleep), and rapid eye movement (REM or paradoxical sleep) states.

What was found

The abstract reports no numerical findings or statistical measures. It details qualitative physiological frameworks: wakefulness is driven by serotonergic, noradrenergic, cholinergic, and hypocretin systems; slow-wave sleep is promoted by circadian signals from the suprachiasmatic nucleus, homeostatic accumulation of adenosine, and GABAergic activation in the ventrolateral preoptic, parafacial, accumbens, and reticular thalamic nuclei; and REM sleep transitions are governed by interactions among glutamatergic and GABAergic neuronal populations in the posterior hypothalamus and brainstem.

Why it matters

It outlines the canonical multi-system neurochemical and anatomical framework used to explain sleep-wake regulation and vigilance state switching.

Limits

The publication is a descriptive narrative review without original clinical data, quantitative effect estimates, or systematic study selection criteria, relying heavily on mechanistic hypotheses from animal and preclinical models.

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