No es tan sencillo como "Te pondré a dormir": una perspectiva neurobiológica sobre la sedación / It is not as simple as "I will put you to sleep": A neurological perspective on sedation

ABSTRACT

The editorial presented in this issue by Dr. Ramsay, "The biological cost of depressed consciousness" is an appeal for us to bear in mind the deleterious consequences of an altered state of consciousness (sedation), particularly in the Intensive Care Unit (ICU). I believe, for example, in the need to consider the significant two-way relationship between sleep disorders and Alzheimer's disease (AD), documented more than one decade ago. Sleep disorders are early indicators of dementia and may manifest before cognitive symptoms. There are basically two pathological process happening in AD: the first is the abnormal biochemical processing of a transmembrane protein called amyloid precursor protein, leading to the production, among other substances, of a toxic pep-tide known as amyloid beta 42 (A-ß42) that accumulates and forms extracellular plaques in the brain; the second is the altered tau protein, a protein associated with the microtubules which is hyperphosphorylated and aggregated in different ways in AD. Tau protein abnormalities are also found in other fatal neurodegenerative diseases causing dementia or movement disorders. Experiments in rodents and correlation studies in humans have shown that chronic changes in sleep architecture induce amyloid and tau disorders, that is to say, a fatal vicious circle.