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        New Message Board Archives >> 2005 Cluster Headache Specific Posts >> REM sleep and wake up clusters
        
(Message started by: violet on Jul 24^th, 2005, 12:09pm)

Title: REM sleep and wake up clusters
Post by violet on Jul 24^th, 2005, 12:09pm

Is REM sleep a trigger? I always get the wake up migraines in the middle of my REM cycle.
Anybody know much about it?
Thank You,
Vi

Title: Re: REM sleep and wake up clusters
Post by burnt-toast on Jul 24^th, 2005, 1:31pm

From some of what I have read CH occurs during the transition between REM sleep to non-REM sleep.

As I frequently get attacks a few hours into sleep I can agree to a point. In my opinion this theory falls apart due to daylight attacks and attacks that occur during rest periods that do not involve sleep.

Where REM to non-REM sleep may be a factor I believe it is only one of several factors associated with CH. It appears that the medical community also recognizes CH and sleep disorders as seperate issues even though they are frequently mentioned together in the same research.

Tom

Tom

Title: Re: REM sleep and wake up clusters
Post by maffumatt on Jul 24^th, 2005, 3:30pm

Supposedly around 80% of CH suffers have sleep apnea. When the O2 level drops in the blood the vessels enlarge to get moree blood to your brain triggering an attack. Floridian should have more info on this subject.........

Title: Re: REM sleep and wake up clusters
Post by Margi on Jul 24^th, 2005, 4:01pm

well, the only "official" trigger is nitro-glycerine but most clusterheads find that REM sleep is a biggie, too. That's why taking benadryl OR gravol/dramamine before bed is a good idea. Both prevent you from reaching REM so you can avoid those attacks. You can only take it for a short period of time (7 days max in a row, I've been told) because REM deprivation sets in and it's not pretty.

Melatonin actually promotes REM sleep but, for some reason, maybe a different level of REM? It helps prevent wakeup cluster as well.

Violet, you mention that you're being woken up by a migraine though...kind of uncommon for a migraine to do that - it's more probable that it will hit you just after you normally wake up. Not in the middle of the night. Do you have migraine or cluster?

Title: Re: REM sleep and wake up clusters
Post by violet on Jul 24^th, 2005, 5:21pm

I have clusters, and it seems to me like the pain wakes me up. I'll be sleeping and dreaming, and then the next thing I know there's this nagging pain tearing me out of my sleep!
Thank you everyone for your input.

Title: Re: REM sleep and wake up clusters
Post by millie the episodic on Jul 24^th, 2005, 8:00pm

:)Would someone please explain REM and non REM sleep?

Title: Re: REM sleep and wake up clusters
Post by burnt-toast on Jul 24^th, 2005, 8:12pm

REM sleep is associated with Rapid Eye Movement that begins while dreaming during sleep and is considered the most active period of the sleep cycle. There are several stages of sleep and the following link will provide more information.

http://www.sleepdisorderchannel.net/stages/

Tom

Title: Re: REM sleep and wake up clusters
Post by unsolved1 on Jul 24^th, 2005, 8:15pm

"Nagging pain" ?? [smiley=huh.gif]

Usually, if I get woke up by a headache ... it's a MONSTER !!

Unsolved

Title: Re: REM sleep and wake up clusters
Post by Kris_in_SJ on Jul 24^th, 2005, 8:23pm

Floridian once explained to me why Melatonin causes such vivid dreams, yet seems to help with night hit clusters. I love Floridian, but sometimes have trouble interpreting his answers (sorry, Flo).

Regardless, Melatonin taken in doses of around 6-9mg before bed seems to really help with those nasties that wake you up. Plus ... Melatonin seems to replace an ingredient that many clusterheads are short of - Seratonin - one of the factors (or lack of) that the experts seem to agree contribute to our problem. I've found it a great help, while Benedryl and other sleep aids seem to help very little.

Good luck - Give it a try!

Kris

Title: Re: REM sleep and wake up clusters
Post by millie the episodic on Jul 24^th, 2005, 8:28pm

I agree that 'nagging pain" and cluster headache don't go well together, especially when you are trying to describe the pain that us clusterheads have to go through. :o
Try another adjective.

Title: Re: REM sleep and wake up clusters
Post by wip5150 on Jul 24^th, 2005, 9:51pm

on 07/24/05 at 15:30:09, maffumatt wrote:

I have sleep apnea and have episodic clusters. Besides that, I'm a party!!

Title: Re: REM sleep and wake up clusters
Post by mcf69 on Jul 25^th, 2005, 12:42am

Being woken from sleep is one of the classic symptoms of Cluster Headaches. I am episodic and the only time I get hit is at night, and I do have sleep apnea, I don't beleive it is a trigger but rather that it aggravates CH. If you get hit alot at night, I'd say have a sleep study done and see if you do have a sleep related breathing disorder which may be contributing to the CH attacks.

Title: Re: REM sleep and wake up clusters
Post by Topical on Jul 25^th, 2005, 4:27am

I get hit sometimes one hour after sleeping and REM hasn't kicked. I believe the actual time is more of a factor than the dreaming.

Title: Re: REM sleep and wake up clusters
Post by Margi on Jul 25^th, 2005, 9:47am

on 07/24/05 at 20:23:59, Kris_in_SJ wrote:

while Benedryl and other sleep aids seem to help very little.

Kris

Just for clarification, Kris, Benadryl isn't a sleep aid, nor is Dramamine/Gravol. Benadryl is an anti-histamine that just happens to cause sleep as a side effect. The anti-histamine aspect also helps clusterheads in that it breaks down some of the congestion that is so common. Dramamine is an anti-nauseant that also has the same side effect of producing sleep. Neither one will allow REM sleep, though, and that's the objective to combat night-time cluster attacks. I agree with you that "sleep aids" don't help - they don't. The reason they don't is that they promote REM sleep.

Benadryl and Dramamine really have helped quite a few clusterheads here, so it's probably not accurate to generalize them into the "sleep aids" category.

Sorry, Violet, I was confused by your first post where you said that you "get the wake up migraines" - that's why I asked if you were suffering from cluster. I've never heard it described as nagging pain before though. I wish the pain that I see radiating from my husband COULD be classified as "nagging". In our house though, a better description would be "horrific, inhumane, stupid pain." :(

Title: Re: REM sleep and wake up clusters
Post by jcmquix on Jul 26^th, 2005, 4:01pm

I have a question to ask.. well I don't know if its a question but here goes..

I usually only get my cycles 2 times a yr (June-Aug & Dec-Feb). But before now I went almost 3yrs PF. Until I started this June 1st, each cycle last almost 90days exactly.

Anysways since I have logged on here I started taking 9-12mg Melatonin & 50mg Benadryl at bedtime each night (about July 1st). It has not stopped the hits, but has really reduced them alot.

The question is should I be taking the Benadryl everynight ? Is it bad to use it daily ?

Its just that I have had a pretty easy go in the last few weeks, they are usually my worst. I don't want to change anything and give the BEAST an opening, but if I am hurting myself I want to know.

Thanks, PFDAN's to ALL !!!!

Charlie

Title: Re: REM sleep and wake up clusters
Post by Topical on Jul 26^th, 2005, 4:34pm

"The question is should I be taking the Benadryl everynight ? Is it bad to use it daily ?"

Call up the doc's office and find out. No appt. should be necessary and no charge either. I wouldn't ask a pharmacist as sometimes we are given meds in an untraditional way, so to speak. Usually the nurse relays the question and will be calling you back within the day.

Title: Re: REM sleep and wake up clusters
Post by Bob P on Jul 26^th, 2005, 5:13pm

I get hit 1 1/2 hours after falling asleep.
When not in a cycle I still wake up 1 1/2 hours after falling asleep.

I get hit during REM,
I get hit during the day.

I only have cluster episodically,
but I have apnea constantly.

Clusters only happen to the dumb and ugly,
that's why I have clusters!

Title: Re: REM sleep and wake up clusters
Post by Kris_in_SJ on Jul 26^th, 2005, 8:48pm

According to the things I've read, Benedryl taken in doses of up to 75mg/night will do nothing to hurt you - even over long periods of time. It's primary side effect is grogginess in the AM.

When I'm in cycle, I take 9mg Melatonin and 25mg Benedryl. I might be a little groggy in the morning, but it really helps with the night hits. Benedryl alone didn't do it for me. If it works for you, be assured you aren't hurting yourself.

Kris

Title: Re: REM sleep and wake up clusters
Post by millie the episodic on Jul 26^th, 2005, 11:08pm

I am a clusterhead and I am neither dumb nor ugly, but I will except CRAZY! :o
I have been at the neuro ALL DAY, with wires hanging out of my hair. My husband called me the bionic woman, because people were staring when we went out to smoke.
The doc seems to think that I am having mini epitiletic seizures, but I told her that they were the occassional stabs or shadows that wake me up or make me jerk myself awake.
She added 250mg Depakote in the mornings. She also was concerned about my thyroid levels being low. She say that I didn't even get to level two sleep.
How can I get an overnight study so that maybe they can meet the monster? :-/

Millie

Title: Re: REM sleep and wake up clusters
Post by floridian on Jul 27^th, 2005, 1:17pm

on 07/24/05 at 16:01:35, Margi wrote:

well, the only "official" trigger is nitro-glycerine but most clusterheads find that REM sleep is a biggie, too. T

Melatonin actually promotes REM sleep but, for some reason, maybe a different level of REM? It helps prevent wakeup cluster as well.

"Official" trigger in whose book? ;)

From what I have read, melatonin does not change the structure of sleep - the same proportion of time is spent in REM, delta, etc. Antihistamines and sleeping pills, on the other hand, do change the structure of sleep.

Melatonin seems to improve postural tone in REM, which probably reduces apnea:

Quote:

M increases the release of serotonin (5-HT), a neurotransmitter which enhances the postural tone by acting on the dorsal pRF: on the other hand, deficits in M levels may lower the activity of the serotoninergic raphe system, thus leading to a decrease or suppression of postural activity similar to that occurring either during REM sleep or during the cataplectic episodes typical of narcoleptic patients;

Arch Ital Biol. 2002 Apr;140(2):129-58. Pineal gland hormone and idiopathic scoliosis: possible effect of melatonin on sleep-related postural mechanisms. Pompeiano O, Manzoni D, Miele F. Dipartimento di Fisiologia e Biochimica, Universita di Pisa, Via S. Zeno 31, 1-56127 Pisa, Italy. pompeiano@dfb.unipi.it

A theory on how REM 'induces' cluster and migraine headaches:

Quote:

Schmerz. 2004 Aug;18(4):300-5.

[Sleeping behaviour and headache attacks in cases of primary headache. Possible pathological mechanisms]

Straube A, Forderreuther S. Neurologische Klinik der Universitat Munchen, Standort Grosshadern. astraube@nefo.med.uni-muenchen.de

Headache is connected with sleep quality, e.g. hypnic headache and chronic paroxysmal headache attacks occur preferentially during REM sleep; this is possibly also true for cluster headache and migraine. REM sleep is typically characterized by the occurrence of ponto-geniculo-occipital spikes (PGOs). These PGOs should be able to trigger cortical spreading depression (CSD), which, although often clinically silent, is assumed to be an essential element of a migraine attack and possibly also of other forms of headache. CSDs are considered a correlate of migraine aura. They could lead to the secondary activation of trigeminovascular afferences, which would then induce a headache. Interestingly, illnesses that are comorbid with migraine cause an increase in the amount of REM sleep; conversely, various drugs administered prophylactically for these illnesses reduce the quantity of REM sleep.

Title: Re: REM sleep and wake up clusters
Post by Margi on Jul 27^th, 2005, 2:36pm

on 07/27/05 at 13:17:45, floridian wrote:

"Official" trigger in whose book? ;)

um...Doc Goadsby's book? Isn't it the only thing that will trigger an attack out of cycle?

Thanks for posting that about melatonin/REM - very cool, Flo. You're just a walking encycloapaedia, man! We'd be lost without you here! :)

And, Kris, Benadryl doesn't let you reach REM. REM deprivation can be very serious over extended periods of time. It also reduces congestion. Taking anything long term that causes an effect - be it sleep or decongestion - can cause your body to stop trying to do those things for itself. Please be careful contradicting well known (and valid) precautions, ok?

Title: Re: REM sleep and wake up clusters
Post by Tom on Jul 27^th, 2005, 4:10pm

It's known that a lack of serotonine causes the CH attacks in some way, the following text could explain why REM sleep may trigger CH attacks:

from

http://www.clusterheadaches.org/library/serotonin/sleep.htm

Dr. J. Allan Hobson, professor of psychiatry at Harvard Medical School and director of the Laboratory of Neurophysiology at the Massachusetts Mental Health Center, has spent more than 40 years studying sleep and dreaming. He is author of "The Chemistry of Conscious States" (Little, Brown, 1994).

He describes how our brain chemistry cycles from the dominance of one chemical system to another during wakefulness, slow wave sleep and REM sleep (rapid eye movement sleep, during which most, but not all, dreams occur).

"In order to be awake and aware," he said, "the brain needs two chemicals: noradrenaline and serotonin."

During slow wave sleep (most of the sleep during the night), the levels of these chemicals fall by half. During REM sleep, the levels drop to nearly zero, and brain activity is dominated by neurons using another chemical: acetylcholine.
--------------------------------------------------------------

BTW: The first REM session occurs c. 90 minutes after falling asleep and then in 90 minute intervals after that.

Thomas

Title: Re: REM sleep and wake up clusters
Post by LeeS on Jul 28^th, 2005, 1:26pm

Interesting thread and great link Thomas. I reckon there is a possible link between CH, sleep, dreaming and neurogenesis There appears to be no common consensus in respect of why people sleep; I believe it is so that we are able to dream. There is even less agreement as to the true role of dreaming; although most people do agree that it's essential. I have hypothesised that dreaming is an essential mechanism for 'neurogenesis' in the brain.

The basic hypothesis is that neurogenesis - the birth of new neurons in the brain - only occurs with the correct 'type' and the correct 'amount' of sleep; and perhaps more importantly, the correct type and amount of dreaming. If neurogenesis does not occur at sufficiently robust levels then certain neurological disorders may become apparent, including cluster headache.

Dreaming appears to be regulated by a variety of different chemicals within the brain, including monoamines, neurotransmitters, beta-carbolines, cytokines (IL-1 and TNF), growth hormones etc., and many studies have shown that CH sufferers have an imbalance of some of these chemicals. However, the crucial chemicals that affect dreaming may in fact be the endogenously produced psychoactive methylated tryptamines, including DMT, 5-MeO-DMT, pinoline and bufotenine. These are believed to be produced by the epiphysis (pineal body), a fascinating little gland, which is directly linked to the hypothalamus (more particularly the suprachiasmatic nucleus) via the pineal nerve. Perhaps CH sufferers actually have an 'abnormal' pineal gland, which is causing the irregularity of activity seen within the hypothalamus?

As we know, many traditional prescriptive medications are based on indole ring hallucinogens, but (arguably) none of these appear to be as effective as LSD, LSA or psilocybin/psilocin. Perhaps these unadulterated alternative medications are more effective in mimicking the naturally occurring oneirogenic or somnogenic chemicals, and hence re-set the 'dream-clock' and enable normal neurogenesis to occur?

Early days yet - but I'll pull it all together one day :)

-Lee