Night Headaches Linked
To Temporary Cessation
Of Breathing (Sleep Apnea)
Source: Neurology 2000;54:2302-2306
NEW YORK (Reuters Health) - Most patients with cluster headaches--attacks of stabbing head pain that often occur at night--also have sleep apnea, a condition in which breathing is temporarily interrupted during sleep.
``Around 80% of people with sleep apnea don't know they have it, so it's very likely that people with cluster headaches who have similar breathing disorders won't know it,'' Dr. Ronald D. Chervin, of the University of Michigan in Ann Arbor, told Reuters Health.
Because some sleep apnea patients experience a worsening of cluster headaches, Chervin and his colleagues performed formal sleep studies on 25 men and women with cluster headaches to determine whether they had breathing problems during sleep.
The researchers found that 80% of the headache patients also had sleep apnea, which was defined as having five or more apnea episodes per hour of sleep, according to a report in the June 27th issue of Neurology. Forty-four percent of patients had 10 or more apnea episodes per hour. During such episodes, the upper airway collapses and temporarily halts breathing, causing the sleeper to snort and gasp for breath.
In the study, sleep disordered breathing was especially severe in 10 patients, whose blood levels of oxygen dropped below 90% during sleep, the investigators note. Low oxygen levels were most commonly associated with the occurrence of cluster headaches during the first half of the night, the results indicate.
``Sleep disordered breathing occurred in the majority of patients with cluster headache,'' the authors write. ``Although sleep disordered breathing was common in our sample, no subjects had received this diagnosis before they enrolled in this study,'' they add.
``Patients and their physicians need to recognize this association between cluster headaches and sleep disordered breathing,'' Chervin said. ``Those whose cluster headaches awaken them from sleep or whose cluster headaches are present when they wake up should talk with their doctor about the possibility of undiagnosed sleep apnea,'' advised Chervin.
``Though our study was not designed to test the effectiveness of treating sleep apnea, published cases suggest that most patients whose sleep apnea is treated will experience significant relief of their cluster headaches,'' Chervin said.
Sleep apnea can be treated by wearing a face mask at night that delivers a stream of air through the nose, which keeps the airway open during sleep.
SOURCE: Neurology 2000;54:2302-2306.

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