Obstructive Sleep Apnea and Cluster Headache

Graff‐Radford, Steven B.; Newman, Alan

doi:10.1111/j.1526-4610.2004.446010.x

Cited by 75 publications

(51 citation statements)

References 16 publications

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“…Chervin et al [26] recruited patients with CH and reported that 80% of them had an Apnea/Hypopnea Index of more than 5. Similar fi gures were found in a study done by Graff-Radford and Newman [27], in which 80.64% of the 31 patients diagnosed with ECH also suffered from sleep apnea. More recently, Nobre et al [28] reported a higher prevalence of sleep apnea in patients with CH when compared with the control group (58.3% vs 14.3%, respectively).…”

Section: Discussionsupporting

confidence: 82%

Cluster headache and obstructive sleep apnea: Are they related disorders?

Graff‐Radford

Teruel²

2009

Current Science Inc

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Patients with cluster headache (CH) have a higher prevalence of sleep apnea, and a possible relationship between these two conditions has been proposed. Although patients suffering from CH attacks often wake up from sleep, sleep apnea has been suggested to be a trigger or an associated abnormality in CH. It has been proposed that regulation of the hypothalamus may be responsible for sleep apnea, and that similiarly CH is generated in the hypothalamus. However, there is evidence that CH and obstructive sleep apnea are not causal, but rather parallel processes both generated in the hypothalamus. The exact role that sleep apnea plays in the perpetuation or precipitation of CH is still to be determined. This paper discusses the proposed pathophysiological mechanisms of these two entities and the possible relationship between CH and sleep apnea.

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Section: Discussionsupporting

confidence: 82%

Cluster headache and obstructive sleep apnea: Are they related disorders?

Graff‐Radford

Teruel²

2009

Current Science Inc

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“…A study of 37 cluster headache patients who underwent polysomnography identified an 8.4-fold increase in the incidence of obstructive sleep apnea relative to age-and gender-matched controls (58% vs 14%, respectively), and this risk increased over 24-fold among patients with a body mass index greater than 25 kg/m 2 [24]. This marked increase in the incidence of sleep apnea among cluster headache patients had been reported in earlier research [25,26], and treatment of sleep apnea had been observed to improve cluster headache control [25]. Cluster headache attacks observed on polysomnography were linked to REM sleep [14], at least in cases of episodic cluster, although perhaps not for patients having the chronic form of cluster headache [27].…”

Section: Cluster and Other Trigeminal Autonomic Cephalalgiasmentioning

confidence: 68%

Sleep and headaches

Rains

Poceta²,

Penzien³

2008

Curr Neurol Neurosci Rep

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Sleep has long been recognized to both provoke and relieve headache. Epidemiologic research has associated sleep disorders with more frequent and severe headaches. Chronic daily, awakening, and morning headache patterns are particularly suggestive of sleep disorders, including sleep-related breathing disorders, insomnia, circadian rhythm disorders, and parasomnias. Snoring and other indicators of sleep-disordered breathing are the most commonly studied and are particularly salient because of the potential for headache to improve or resolve with treatment of sleep. In addition to sleep disorders, clinical research correlates specific headache diagnoses (eg, migraine, tension-type, and cluster) with chronobiologic patterns and sleep processes, implicating common anatomic structures and neurochemical processes involved in the regulation of sleep and headache. Evidence strongly supports screening for sleep disorders by headache practitioners. Headache management should identify and treat sleep disorders that may improve or resolve headache.

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“…A study of 37 cluster headache patients who underwent polysomnography identified an 8.4-fold increase in the incidence of OSA relative to controls matched for age and gender (58% vs 14%), and this risk increased more than 24-fold among patients with a body mass index (BMI) greater than 25 kg/m 2 [15]. Another uncontrolled study of 31 cluster headache patients who underwent polysomnography observed OSA in 80% (25/31) of these patients [16]. Likewise, Sand et al [17] reported that patients with OSA were seven times more likely to have chronic headache than the general population.…”

Section: Sleep Disorders Associated With Headachementioning

confidence: 94%

Sleep and Headache

Rains

Poceta

2010

Curr Treat Options Neurol

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Headache has been linked to a wide range of sleep disorders that may impact headache management. There are no evidence-based guidelines, but the authors believe that literature supports the following clinical recommendations: 1. Diagnose headache according to standardized criteria. Specific diagnoses are associated with increased risk for specific sleep and psychiatric disorders. 2. Collect sleep history in relation to headache patterns. Screening questionnaires and prediction equations are cost-effective. 3. Rule out sleep apnea headache in patients with awakening headache or higher-risk headache diagnoses (cluster, hypnic, chronic migraine, and chronic tension-type headache); patients with signs and symptoms of obstructive sleep apnea warrant polysomnography and treatment according to sleep medicine practice guidelines. There is no evidence for suspending conventional headache treatment in suspected or confirmed cases of sleep apnea. Treatment of sleep apnea with CPAP may improve or resolve headache in a subset of patients. The impact on sleep apnea headache of other treatments for sleep apnea (eg, oral appliances, surgery, weight loss) is largely untested. At a minimum, sedative-hypnotic drugs should be avoided in suspected apneics until the sleep apnea is treated. 4. Among patients with migraine and tension-type headache, insomnia is the most common sleep complaint, reported by one half to two thirds of clinic patients. Patients who suffer from chronic migraine or tension-type headache may benefit from behavioral sleep modification. Pharmacologic treatment may be considered on a case-by-case basis, with hypnotics, anxiolytics, or sedating antidepressants used to manage insomnia, tailoring treatment to the symptom pattern. 5. Individuals with chronic headache are at increased risk for psychiatric disorders. Assessment for depression and anxiety may be warranted when either insomnia or hypersomnia is present. Psychiatric symptoms affect the choice of sedating versus alerting versus neutral pharmacologic agents for headache. 6. All headache patients, particularly those with episodic migraine and tension-type headaches, may benefit from inclusion of sleep variables in trigger management.

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Obstructive Sleep Apnea and Cluster Headache

Cited by 75 publications

References 16 publications

Cluster headache and obstructive sleep apnea: Are they related disorders?

Cluster headache and obstructive sleep apnea: Are they related disorders?

Sleep and headaches

Sleep and Headache

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