Morning Headache as an Obstructive Sleep Apnea-Related Symptom among Sleep Clinic Patients—A Cross-Section Analysis

Abstract

Morning headache is considered to be a symptom of obstructive sleep apnea syndrome (OSAS). Despite not being as common as excessive daytime sleepiness or unrefreshing sleep, it can similarly impair everyday activities. The aim of the present study was to evaluate the prevalence of and factors associated with morning headaches (MH) among patients referred for polysomnography due to suspected OSAS. This is a retrospective study on 1131 patients who underwent polysomnography between 2013 and 2015. Morning headaches (MH) were reported in 29% of them. In a logistic regression model, a rise in the n probability of MH was associated with female sex (odds ratio, OR, 1.38, 95% confidence interval, CI, 1.08–1.75), history of hypertension (OR 1.25, 95% CI 1.06–1.46), complaint on unrefreshing sleep (OR 1.42, 95% CI 1.19–1.70), choking at night (OR 1.25, 95% CI 1.05–1.49), and fall in total sleep time (OR 0.872 per each hour, 95% CI 0.76–0.99). The risk between MH and apnea–hypopnea index, blood oxygen saturation parameters or arousal index was found to be statistically insignificant. There is a lack of evidence that MH is associated with the severity of OSAS or nocturnal hypoxemia.

Current Understanding of the Chronobiology of Cluster Headache and the Role of Sleep in Its Management

“…Whether one can exacerbate the other is also undecided since the severity of the described morning headaches may not be related to the severity of the sleep apnea. [78][79][80] This may also pertain to other headaches and exacerbating and alleviating factors in general.…”

The Epidemiology of Obstructive Sleep Apnea in Poland—Polysomnography and Positive Airway Pressure Therapy

“…Obstructive sleep apnea syndrome (OSAS) is characterized by repeated episodes of partial or complete breathing cessation during sleep due to pharyngeal airway closure [ 1 ]. Common symptoms of OSAS include excessive daytime sleepiness, loud snoring, recurrent arousals during sleep, as well as morning headaches [ 2 ]. The prevalence of OSAS in the adult population is estimated to be 3–7% [ 3 ]; however, some recent studies suggest that OSAS is considerably more frequent and affects up to approximately 84% of men and 61% of women [ 4 , 5 ].…”

“…To the major risk factors for OSAS we can include obesity, hypertension, male sex, and age. Moreover, OSAS leads to the development of many severe health consequences, such as cardiovascular, cerebrovascular, as well as endocrine and metabolic disorders [ 2 , 7 , 8 , 9 , 10 , 11 ]. Furthermore, OSAS is related to impairment in work performance and a higher risk of occupational and industrial accidents [ 12 , 13 ].…”

Uvulopalatopharyngoplasty and barbed reposition pharyngoplasty with and without hyoid suspension for obstructive sleep apnea hypopnea syndrome: A comparison of long-term functional results

“…The risk factors include age, male gender, cigarette smoking, obesity, and abnormal facial anatomy [3,4]. The clinical symptoms are excessive daytime sleepiness [5][6][7], morning headache [8], decrease of cognitive performance [9,10], sexual dysfunction [11], decreased quality of life [12][13][14][15][16], and increased cardiovascular risk [17][18][19][20].…”