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        New Message Board Archives >> 2004 Posts >> another link which I found interesting
        
(Message started by: Reese on Apr 22^nd, 2004, 2:04pm)

Title: another link which I found interesting
Post by Reese on Apr 22^nd, 2004, 2:04pm

This link is about sleep apnea and CH.I do find myself waking up snoring and sometimes gasping for air. Can it be my cause? I doubt it :-X http://www.talkaboutsleep.com/sleepdisorders/Snoring_apnea_cluster.htm

Title: Re: another link which I found interesting
Post by floridian on Apr 22^nd, 2004, 2:45pm

There are 12 articles on PubMed dealing with cluster headaches and sleep apnea - most suggest that for some people, apnea may be a factor. Some people have posted on the board that various devices (mouth-piece, postive air pressure breather) have helped them, but like everything with clusters, no treatment is 100% for everyone.

Quote:

Sleep Res Online. 2000;3(3):107-12.

Timing patterns of cluster headaches and association with symptoms of obstructive sleep apnea.

Chervin RD, Zallek SN, Lin X, Hall JM, Sharma N, Hedger KM.

Sleep Disorders Center, Department of Neurology, University of Michigan, Ann Harbor, Michigan, USA.

Cluster headaches (CH) frequently recur at the same point in the circadian cycle, often during sleep. They may, in some cases, represent a susceptible individual's response to hypoxemia or other physiological changes induced by obstructive sleep apnea (OSA). If and when this mechanism exists, timing of CH close to the onset of sleep-and therefore OSA-might be expected. We questioned 36 subjects with CH about the times at which their CH usually occurred and about several symptoms known to be predictive of OSA, including habitual snoring, loud snoring, observed apneas and excessive daytime sleepiness. We then used logistic regression to determine whether occurrence of CH in each of six time periods was associated with OSA symptoms. The 23 subjects (64%) who reported CH in the first half of a typical night's sleep also tended to report headaches during the midday/afternoon period. Symptoms of OSA, and in particular habitual snoring, were predictive of both first-half-of-the-night and midday/afternoon CH (p<.05). Thirty-one subjects (86%) reported that their CH were sleep-related, usually occurring during any part of the night or on awakening, but symptoms of OSA were not predictive of this timing pattern. In short, several OSA symptoms showed an association with CH occurrence in the first half of the night but not with sleep-related CH in general. These findings suggest that in some patients, physiological consequences of OSA may trigger CH during the first few hours of sleep and thereby influence the timing of subsequent daytime headaches.

Title: Re: another link which I found interesting
Post by Tiannia on Apr 22^nd, 2004, 5:56pm

My doc is making me take a sleep test. We'll see what it shows. Some how I think my husband has it more then I do, maybe this will explain why he is a pain in the ass.... oh damn that is the wrong end. ;;D

Title: Re: another link which I found interesting
Post by Bob P on Apr 22^nd, 2004, 6:11pm

In floridians article above, I spoke with Dr. Chervin shortly after he published this article. He said that cluster was such a complicated disorder, that he doubted apnea had a big roll in it and most probably was not a cause for clusters.

I think it's just because cluster sufferers are just a bunch of big fat, chain smoking alcoholics, they just snore a lot (this only applies to women with clusters, you know the ones with facial hair).

BTW - the part about talking with Chervin is true.

Title: Re: another link which I found interesting
Post by floridian on Apr 22^nd, 2004, 8:23pm

Chervin may be right, I don't know for sure. But here are some thoughts:

High oxygen levels can abort.
Apnea leads to very low oxygen levels.
Apnea is most common in REM
Clusters most commonly start in REM (for episodics who sleep)
Some people have reported an end of headaches when apnea is corrected.

It could be that an impaired hypothalamus causes apnea, not the other way around. Or that they co-occur.

My headaches are more the 'alarm-clock' pattern - at the begining of a cycle, they are at 6 am, then 4:30 and 6:00, progressing to midnight through 10:00 am. That pattern is not strongly associated with apnea, but is associated with reduced fat metabolism while sleeping (which may be driven by the hypothalamus).

Quote:

Cephalalgia. 2003 May;23(4):276-9.

Cluster headache associated with sleep apnoea.

Nobre ME, Filho PF, Dominici M.

Universidade Federal Fluminense, Rio de Janeiro, Brasil. eduarda@imagelink.com.br

This study of sleep changes in patients with cluster headache (CH) was conducted in view of the nocturnal predominance of this condition, the efficacy of oxygen and the fact that the attacks follow oxygen desaturation. Proposed mechanisms include impairment of carotid body activity secondary to hypothalamic vasomotor regulatory dysfunction. Sixteen patients with episodic CH and 29 healthy volunteers underwent nocturnal polysomnography. Five (31.3%) patients with episodic CH were found to have sleep apnoea (SA). Two patients with SA experienced two attacks during the study period. The attacks followed episodes of oxygen desaturation and were associated with REM sleep. In two patients with SA and CH, treatment with continuous positive airway pressure abolished their oxygen desaturation, sleep apnoeas and headaches. Our study confirmed the high percentage of CH associated with SA. We suggest that oxygen desaturation may be a trigger factor in some patients and play a role in the pathogenesis of CH.