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The field of sleep medicine has grown substantially over the last few decades, in part due to new insights into the neural mechanisms that control sleep and wakefulness. Drawing upon more than 30 years of experience in sleep physiology, McCarley reviews sleep neurobiology with a focus on two important questions: How does the brainstem regulate REM sleep, and how does the sleep-promoting factor adenosine actually produce sleep?
Starting with the evidence from Jouvet’s lesion experiments in the 1960s, McCarley presents a compelling model of the regulation of REM sleep through the interaction of brainstem monoaminergic and cholinergic neurons. He also outlines how adenosine accumulates during wakefulness and inhibits wake-promoting neurons in t…