Sleep Disorders Health Center
Understanding Sleep Problems - The Basics
What Are Sleep Disorders?
Sleep can be divided into two types: rapid eye movement (REM) sleep and non-REM (NREM) sleep. NREM sleep has four stages of increasingly deep sleep. Stage 1 sleep is the lightest, while stage 4 is the deepest.
During normal sleep, you cycle through these types and stages of sleep. But if your sleep is repeatedly interrupted and you cannot cycle normally through REM and NREM sleep, you may feel tired, fatigued, and have trouble concentrating and paying attention while awake. Sleepy individuals are at greater risk for driving and other accidents.
If you have trouble getting to sleep or sleeping through the night, if you wake up too early or have a hard time waking up at all, or if you are overly tired during the day, you may have one of the following sleep problems.
Circadian Rhythm Disorders
Typically, people sleep at night -- thanks not only to the conventions of the 9-to-5 workday, but also to the close interaction between our natural sleep and alertness rhythms, which are driven by an internal "clock."
This clock is a small part of the brain called the suprachiasmatic nucleus of the hypothalamus. It sits just above the nerves leaving the back of our eyes. Light and exercise "reset" the clock and can move it forward or backward. Abnormalities related to this clock are called circadian rhythm disorders ("circa" means "about," and "dies" means "day").
Circadian rhythm disorders include jet lag, adjustments to shift work, delayed sleep phase syndrome (you fall asleep and wake up too late), and advanced sleep phase syndrome (you fall asleep and wake up too early).
Insomnia
People who have insomnia don't feel as if they get enough sleep at night. They may have trouble falling asleep or may wake up frequently during the night or early in the morning. Insomnia is a problem if it affects your daytime activities. Insomnia has many possible causes, including stress, anxiety, depression, poor sleep habits, circadian rhythm disorders (such as jet lag), and taking certain medications.
Snoring
Many adults snore. The noise is produced when the air you inhale rattles over the relaxed tissues of the throat. Snoring can be a problem simply because of the noise it causes. It may also be a marker of a more serious sleep problem called sleep apnea.
Sleep Apnea
Sleep apnea occurs when the upper airway becomes completely or partially blocked, interrupting regular breathing for short periods of time - which then wakes you up. It can cause severe daytime sleepiness. Evidence is building that, left untreated, severe sleep apnea may be associated with high blood pressure and the risk of stroke and heart attack.
Pregnancy and Sleep
Women often experience sleepless nights and daytime fatigue in the first and third trimesters of their pregnancy. During the first trimester, frequent trips to the bathroom and morning sickness may disrupt sleep. Later in pregnancy, vivid dreams and physical discomfort may prevent deep sleep. After delivery, the new baby's care or the mother's postpartum depression may interrupt sleep.
WebMD Medical Reference
TOPAMAX is approved for migraine prevention in adults only.
TOPAMAX is not used to stop a migraine after it starts.
IMPORTANT SAFETY INFORMATION
Serious risks associated with TOPAMAX include lowered bicarbonate levels in the blood resulting in an increase in the acidity of the blood (metabolic acidosis). Symptoms could include hyperventilation (rapid, deep breathing), tiredness, loss of appetite, irregular heartbeat or changes in the level of alertness. Call your doctor immediately if you get these symptoms. Your doctor may want to do simple blood tests. Chronic, untreated metabolic acidosis may increase the risk for kidney stones or bone disease.
Other serious risks include decreased sweating, increased body temperature, kidney stones, sleepiness, dizziness, confusion, difficulty concentrating, and increased eye pressure (glaucoma). Call your doctor immediately if you have any decrease in vision or eye pain. These problems can lead to blindness if not treated right away.
More common side effects are tingling in arms and legs, loss of appetite, tiredness, nausea, diarrhea, taste change and weight loss.
Tell your doctor about other medications you take. Please see full U.S. Prescribing Information.
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