Second Look Neurology

Salute your microbiome.

For anyone who's doing this and wants my input, I'm here to help.

New CGRP meds for migraine. Expensive biologicals. but they are an alternative.

This applies to a small minority of stroke patients but can be life altering.

I've been delving into the role of Adenosine in sleep induction. Adenosine affects neural receptors to induce sleep but it isn't a neurotransmitter but more of a hormone bc it is not secreted by a presynaptic neuron but rather accumulates. Caffeine is chemically similar to adenine (also a purine) and blocks adenosine receptors, enhancing wakefulness. Adenosine accumulates over your waking period until reaching a threshold where it induces sleep. Mainly adenosine accumulates w...hen the main energy molecule in your body, ATP, converts to AMP and adenosine but also via other mechanisms and enzymes. Presumably adenosine accumulates with fatigue. Cardiologists use adenosine intravenously to slow atrial tachcardia so like a lot of chemical signals it is widely available and has widespread effects. It's the location of specific receptors that gives Adenosine its effects. Where I'm going with this is when occasionally I can't sleep and espeially when I wake up after a dream in the middle of the night and have trouble falling asleep again, I have found it to be useful to exercize heavily and then fall asleep nicely. I used to do aerobic exercise as in running and that works to some extent though it can also keep me up. Recently I have found that a brief vigorous regimen of resistive exercise including pullups and pushups and weights done intensively for just minutes gets me to sleep. I am wondering if that might increase brain Adenosine via the mechanism of burning ATP. If I have done physical exercise by day, I often want to take a nap, maybe for the same reason. I don't find a lot written about exercize esp resistive exercize as a good prn treatment for insomnia. Everyone recommends exercise to insomniacs but daily exercise. I am interested to know if there is more written about this and especially other personal experiences.