Changes in headache characteristics with oral appliance treatment for obstructive sleep apnea

Abstract

Changes in headache characteristics in obstructive sleep apnea (OSA) patients following oral appliance treatment was investigated for the first time. Thirteen OSA patients with headaches treated with a mandibular advancement device were investigated. Level I polysomnography and Migraine Disability Assessment Questionnaire were completed before and after treatment. Various headache characteristics and concomitant conditions were analyzed. The patient was considered a headache responder when ≥ 30% reduction in headache frequency following treatment. Differences in headache and polysomnographic parameters were compared between headache responder groups. Eight patients (62%) were headache responders. Eleven patients (85%) before and 7 (54%) after treatment reported morning headaches. Significantly more patients had bilateral headache in the responder group before treatment (P = 0.035). The severest headache intensity (P = 0.018) at baseline showed a significant decrease in the headache responder group after treatment. The time spent in N2 (r = − 0.663, P = 0.014), REM sleep (r = 0.704, P = 0.007) and mean oxygen saturation (r = 0.566, P = 0.044) showed a significant correlation with post-treatment average headache intensity. Pre-treatment lower PLM index (r = − 0.632, P = 0.027) and higher mean oxygen saturation levels (r = 0.592, P = 0.043) were significantly correlated with higher post-treatment severest headache intensity. Treatment with an oral appliance is beneficial for many OSA patients with headaches. It should be considered as an alternative treatment in headache patients with mild to moderate OSA.

Prevalence and factors correlated with hypertension secondary from obstructive sleep apnea

“…These data may indicate that though morning headache is associated with hypertension in patients with OSA, the causes may be multifactorial. Finally, headache in patients with OSA may be related to sleep bruxism, which may be improved by using an oral appliance [ 27 ].…”

Metabolic Aspects of Migraine: Association With Obesity and Diabetes Mellitus

“…Besides, obesity and obstructive sleep apnea are strongly associated ( 159 ). In this respect, patients with migraine, especially older men with chronic migraine and a high BMI, seem to have a high risk of sleep apnea, whose treatment (e.g., with an oral appliance) might be beneficial in some patients ( 160 , 161 ). To date, the causal relationship between obstructive sleep apnea and migraine has not been established, although this sleep disturbance may be a trigger factor that could accelerate migraine progression ( 162 ).…”

More than sleepiness: prevalence and relevance of nonclassical symptoms of obstructive sleep apnea

“…Recent research has shown that PAP therapy may increase pain tolerance and threshold [ 73 ]. Park et al [ 74 ] evaluated the change in headache prevalence in consecutive OSA patients who were treated with MAD. Eleven patients (85%) before and seven patients (54%) after treatment reported morning headache.…”