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Sleep, Narcolepsy, and Sodium Oxybate

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Date 2021 Apr 8
PMID 33827411
Citations 4
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Abstract

Sodium oxybate (SO) has been in use for many decades to treat narcolepsy with cataplexy. It functions as a weak GABAB agonist but also as an energy source for the brain as a result of its metabolism to succinate and as a powerful antioxidant because of its capacity to induce the formation of NADPH. Its actions at thalamic GABAB receptors can induce slow-wave activity, while its actions at GABAB receptors on monoaminergic neurons can induce or delay REM sleep. By altering the balance between monoaminergic and cholinergic neuronal activity, SO uniquely can induce and prevent cataplexy. The formation of NADPH may enhance sleep's restorative process by accelerating the removal of the reactive oxygen species (ROS), which accumulate during wakefulness. SO improves alertness in normal subjects and in patients with narcolepsy. SO may allay severe psychological stress - an inflammatory state triggered by increased levels of ROS and characterized by cholinergic supersensitivity and monoaminergic deficiency. SO may be able to eliminate the inflammatory state and correct the cholinergic/ monoaminergic imbalance.

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References
1.
BOEHME R, Baker T, Mefford I, Barchas J, Dement W, Ciaranello R . Narcolepsy: cholinergic receptor changes in an animal model. Life Sci. 1984; 34(19):1825-8. DOI: 10.1016/0024-3205(84)90675-1. View

2.
Zhong P, Zhang Z, Barger Z, Ma C, Liu D, Ding X . Control of Non-REM Sleep by Midbrain Neurotensinergic Neurons. Neuron. 2019; 104(4):795-809.e6. DOI: 10.1016/j.neuron.2019.08.026. View

3.
Denis D, French C, Gregory A . A systematic review of variables associated with sleep paralysis. Sleep Med Rev. 2017; 38:141-157. DOI: 10.1016/j.smrv.2017.05.005. View

4.
Li S, De Lecea L . The hypocretin (orexin) system: from a neural circuitry perspective. Neuropharmacology. 2020; 167:107993. DOI: 10.1016/j.neuropharm.2020.107993. View

5.
Toossi H, Del Cid-Pellitero E, Jones B . Homeostatic regulation through GABA and acetylcholine muscarinic receptors of motor trigeminal neurons following sleep deprivation. Brain Struct Funct. 2017; 222(7):3163-3178. PMC: 5585289. DOI: 10.1007/s00429-017-1392-4. View