Established the action of hypnotic-sedating on the GABA-A receptors, we believe this cannot be the only mechanism responsible for the subjective feeling of improvement of sleep, and there must be other mechanisms in relation to efficacy and tolerability/safety to the drugs. Probably these mechanisms are related not only to composition and heterogeneity of the distinct subtypes of GABA-A receptors, but also to their regional and cellular distribution, as well as to the subcortical interactions that must regulate, at the least, the hypothalamic control of sleep-vigil cycles.
Moreover, the improvement in organization of sleep manifested by a decrease in its fragmentation and a fewer number of micro-awakenings in the patients treated with benzodiazepines or hypnotic non-benzodiazepinic group-Z drugs, seems to contribute to this subjective improvement despite a superficialization of the total time of sleep. Studies on the different subtypes of GABA-A receptors apart from the majoritariana-1 in relation to the hypothalamic-subcortical interaction occurring globally during insomnia, might open new paths of research for the development of more selective drugs which will induce a more efficient, deep and repairing sleep, with less adverse effects.
Last date updated on June, 2014