CN-037 Clin Nav.indd

CME Outfi tters designates this enduring material for a maximum of 1 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. STATEMENT OF NEED Insomnia can affect many aspects of an individual’s life— impairing concentration and memory, increasing the risk of incident depression or recurrence of a depressive episode, diminishing the patient’s ability to enjoy family and social relationships, and increasing the risk for falls, and motor vehicle accidents. Clinical research provides evidence that insomnia is a disorder of hyperarousal demonstrated by a number of physiologic measures, such as increased heart rate.1 It is hypothesized that hyperarousal may occur in association with a shift in the balance between systems that promote sleep and those that promote wakefulness. This neuroscienceCME Clinical Navigator is the fi rst of a twopart series, and will describe the neurobiology of the sleep-wake system so that clinicians understand more about the role of neurotransmitters, including orexin, and the nature of how the hyperarousal state may lead to insomnia.