Orexin Receptor Antagonism: Normalizing Sleep Architecture in Old Age and Disease.

IF 11.2 1区 医学 Q1 PHARMACOLOGY & PHARMACY
Jarrah O-Z J Kron, Ryan J Keenan, Daniel Hoyer, Laura H Jacobson
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引用次数: 0

Abstract

Sleep is essential for human well-being, yet the quality and quantity of sleep reduce as age advances. Older persons (>65 years old) are more at risk of disorders accompanied and/or exacerbated by poor sleep. Furthermore, evidence supports a bidirectional relationship between disrupted sleep and Alzheimer's disease (AD) or related dementias. Orexin/hypocretin neuropeptides stabilize wakefulness, and several orexin receptor antagonists (ORAs) are approved for the treatment of insomnia in adults. Dysregulation of the orexin system occurs in aging and AD, positioning ORAs as advantageous for these populations. Indeed, several clinical studies indicate that ORAs are efficacious hypnotics in older persons and dementia patients and, as in adults, are generally well tolerated. ORAs are likely to be more effective when administered early in sleep/wake dysregulation to reestablish good sleep/wake-related behaviors and reduce the accumulation of dementia-associated proteinopathic substrates. Improving sleep in aging and dementia represents a tremendous opportunity to benefit patients, caregivers, and health systems.

催产素受体拮抗剂:使老年和疾病患者的睡眠结构正常化
睡眠对人类的健康至关重要,但随着年龄的增长,睡眠的质量和数量都会下降。老年人(年龄大于 65 岁)更容易因睡眠不足而患上和/或加重各种疾病。此外,有证据表明,睡眠中断与阿尔茨海默病(AD)或相关痴呆症之间存在双向关系。奥曲肽/甲状腺素神经肽能稳定觉醒,有几种奥曲肽受体拮抗剂(ORAs)已被批准用于治疗成人失眠症。老龄化和注意力缺失症会导致奥曲肽系统失调,因此奥曲肽受体拮抗剂对这些人群具有优势。事实上,多项临床研究表明,奥拉西坦对老年人和痴呆症患者是有效的催眠药,而且与成人一样,一般都能很好地耐受。在睡眠/觉醒失调的早期使用催眠药,以重建良好的睡眠/觉醒相关行为,减少痴呆症相关蛋白病理底物的积累,可能会更有效。改善老龄化和痴呆症患者的睡眠是造福患者、护理人员和医疗系统的巨大机遇。
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来源期刊
CiteScore
27.80
自引率
0.00%
发文量
53
期刊介绍: Since 1961, the Annual Review of Pharmacology and Toxicology has been a comprehensive resource covering significant developments in pharmacology and toxicology. The journal encompasses various aspects, including receptors, transporters, enzymes, chemical agents, drug development science, and systems like the immune, nervous, gastrointestinal, cardiovascular, endocrine, and pulmonary systems. Special topics are also featured in this annual review.
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