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HeadWay, Issue #066 -- Sleep Apnea, Headache and Migraine
February 21, 2009

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In this month's issue:

Sleep Apnea - triggering headaches?

What is Migraine?

Sleep Apnea - triggering headaches?

Yes, it could be that something called sleep apnea (or sleep apnoea) is triggering your headaches or migraine attacks.  So it's about time we took a closer look at sleep apnea and the how it's related to symptoms you may be experiencing right now.

What is sleep apnea?

People with sleep apnea either stop breathing, or take shallow breaths, over and over while sleeping.  We could be talking about hundreds of times.  Afterward, the person is partially roused from sleep and they usually catch up by taking deeper breaths.

Sleep apnea is actually very common, but often goes undiagnosed.  To actually be diagnosed, you will usually need a nocturnal polysomnography.  This is actually a set of tests that are performed while you sleep.  This, of course, is not a normal test given to people with headache or migraine, and it's not always easy for a doctor to tell if you have sleep apnea from an office visit.

There are three types of sleep apnea - obstructive (the most common), central, and mixed.

Sleep Apnea and Cluster Headache

Several years ago it was discovered that many - perhaps most - cluster headache patients also had sleep apnea.  Researchers are far from suggesting that sleep apnea causes cluster headache, but it could be a factor.  For now, we do know that breathing, oxygen and sleep are all key in treating cluster headache.  It would be worth checking out and treating your sleep apnea if you are a clusterhead.

Migraine and Sleep Apnea

Again, though sleep apnoea is unlikely to be a cause of migraine, it could be triggering attacks.  In fact, it's almost certainly a factor in those patients who have migraine and sleep apnea.  Any kind of sleep problem is likely to increase the frequency and severity of your attacks.

Neurologist and sleep specialist James R. Weintraub of the Michigan Headache and Neurological Institute suggests that there is a direct correlation between migraine attacks and the number of REM (rapid eye movement) periods in your sleep (same relationship, just more pronounced, in cluster headache).  Read more here.

A recent study showed a relationship between sleep disorders in children and youth and migraine.  The study was of people who had already reported headache and sleep problems.  It was found that the patients with migraine were significantly more likely to have sleep breathing disorders (read the details).


Headaches in general are a common symptom of sleep apnea.  Particularly morning headaches.  But let's take a closer look at the symptoms of, and dangers from, sleep apnea.

What should I do?

First, do you have symptoms of sleep apnea?  A common symptom is snoring, or snorting loudly at night.  When you wake up, you may feel tired and you may be sleepy throughout the day.  You may awake with a sore or dry throat.  You may have a morning headache, and have trouble staying asleep at night.

In children, the symptoms may be different.  There may be snoring, but often a child does not become more drowsy during the day, but actually more hyper.  Some of you parents will know what I'm talking about.

Sleep apnea can have serious consequences.  We've already talked about headache and migraine.  But it can also increase the risk of heart attack and other heart issues, diabetes, and of course accidents and decreased productivity due to drowsiness.

If you have some of the symptoms of sleep apnea, talk to your doctor about it, and consider having a sleep test done.  Sometimes sleep tests are not the final answer, but in many cases you can find out right away if you have sleep apnea.  Then a number of treatments are available, such as a dental device, a breathing mask (CPAP, ASV, oxygen or BiPAP), and surgery.

Could I treat myself?

It is wise to see your doctor.  In many cases, some kind of special treatment will be needed, and it's important to look into your options.

However, depending on how severe your sleep apnea is, you may be able to see a significant improvement with some lifestyle changes.  Doctors often recommend losing weight and avoiding alcohol and sleeping pills.  But there are two other possible solutions that many people don't know about.

First, many patients find significant improvement just by changing their sleeping position, and sleeping on their side and not their back.

Second, a new study on sleep apnea from the Toronto Rehabilitation Institute in Canada suggests that being sedentary much of the day may cause sleep apnea in some people.  Fluid accumulates in your legs if you sit a lot, then redistributes when you sleep.  Frequently getting up and walking around may make a more significant improvement than was previously believed.

If fluid changes really are the culprit, another possible option would be to raise the head of your bed.

Read more about sleep apnea at the Mayo Clinic.

What is Migraine?

Since this was a particularly long article, I'm not going to write any more this month.  However, I just want to let you know that I've finished the "What is Migraine?" series.  Check it out, and don't miss people's comments:These are excellent articles to share with someone who is trying to understand migraine, or to link to from your website.  The information includes some of the most cutting edge research into migraine disease.  Check them out!

Thanks for reading!  Remember, if you have feedback or ideas for future issues, visit the HeadWay MailRoom.  Your password is nomoache.
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