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        Cluster Headache Help and Support >> Cluster Headache Specific >> sleep apnea or sleep study
        
(Message started by: beachmusic on Mar 1^st, 2008, 8:22am)

Title: sleep apnea or sleep study
Post by beachmusic on Mar 1^st, 2008, 8:22am

I have a question for everyone. Has anyone or many here had a sleep study done and if so have many been diagnosed with sleep apnea?
Did the Cpap treatment help with headaches and how does that oxygen therapy compare to the high flow o2 treatment that is recommended for cluster sufferer's??
I failed the first half of a sleep study 4 years ago I never returned for the 2nd portion of the test because I knew I was not going to wear a mask nightly. I felt I failed due to being overweight but I have since lost any extra pounds and then some! But as I have said before I have serious sleep issues and I know the doctor will recommend I do another sleep study.
If I fail again I just want to be educated and not waste my time treating anything except these headaches!!!

Title: Re: sleep apnea or sleep study
Post by DennisM1045 on Mar 1^st, 2008, 8:43am

There is a high correlation between CH and SA that has been documented in a few studies.

http://www.blackwell-synergy.com/doi/abs/10.1046/j.1468-2982.1984.0401033.x?cookieSet=1&journalCode=cha

Quote:

Sleep apnea in cluster headache
Lee Kudrow, Dennis J McGinty, Elliott R Phillips, Michael Stevenson (1984)

The impetus to study sleep changes in a cluster population arose from a recent hypothesis that predicted the finding of sleep apnea in this disorder. It holds that cluster attacks may occur in response to oxygen desaturation. Proposed mechanisms involve impairment of carotid body activity secondary to hypothalamic-vasomotor regulatory dysfunction. Five chronic and five episodic cluster patients underwent nocturnal polysomnography, utilizing standard equipment for monitoring sleep status, cardiac activity, nasal and buccal air flow change, chest and abdominal breathing, muscle activity and oxygen saturation. All episodic patients and one of five chronic patients were found to have sleep apnea (60%). Mean apneas per hour during NREM sleep were similar to that of REM sleep; 26.7 and 28.2, respectively. Six patients with sleep apnea experienced 14 cluster headache attacks during the study period. Eight attacks (57%) followed episodes of oxygen desaturation ranging from 65% to 85%. In the sleep apnea group, 8 out of 14 attacks (57%) were associated with REM; three without, and five following oxygen desaturation. Of the non-apnea group, all of whom had chronic cluster headache, none of 5 attacks were associated with oxygen desaturation, and only 2/5 attacks occurred in relation to REM. Thus, our study showed that sleep apnea was a common finding in a randomly selected group of episodic cluster patients; and most nocturnal attacks were preceded by oxyhemoglobin desaturation and REM-related. These findings were uncommon in the chronic cluster group.

Here is a list of other research that has followed:

Quote:

DD Mitsikostas, M Vikelis & A Viskos. (2008) Refractory chronic headache associated with obstructive sleep apnoea syndrome. Cephalalgia 28:2, 139–143

Jeanetta C. Rains, PhD; J. Steven Poceta, MD. (2006) Headache and Sleep Disorders: Review and Clinical Implications for Headache Management. Headache: The Journal of Head and Face Pain 46:9, 1344–1363

ME Nobre, AJ Leal & PMF Filho. (2005) Investigation into sleep disturbance of patients suffering from cluster headache. Cephalalgia 25:7, 488–492

Steven B. Graff-Radford, DDS; Alan Newman, DDS. (2004) Obstructive Sleep Apnea and Cluster Headache. Headache: The Journal of Head and Face Pain 44:6, 607–610

ME Nobre, PFM Filho & M Dominici. (2003) Cluster headache associated with sleep apnoea. Cephalalgia 23:4, 276–279

David W. Dodick, MD, Eric J. Eross, MD and James M. Parish, MD. (2003) Clinical, Anatomical, and Physiologic Relationship Between Sleep and Headache. Headache: The Journal of Head and Face Pain 43:3, 282–292

James R. Weintraub. (2003) Cluster headaches and sleep disorders. Current Pain and Headache Reports 7:2, 150
CrossRef
J. Steven Poceta. (2003) Sleep-related headache syndromes. Current Pain and Headache Reports 7:4, 281
CrossRef
J-P Neau, J Paquereau, M Bailbe, J-C Meurice, P Ingrand & R Gil. (2002) Relationship between sleep apnoea syndrome, snoring and headaches. Cephalalgia 22:5, 333–339

J. Steven Poceta. (2002) Sleep-related headache. Current Treatment Options in Neurology 4:2, 121
CrossRef
Jeanetta C. Rains, Donald B. Penzien. (2002) Chronic headache and sleep disturbance. Current Pain and Headache Reports 6:6, 498
CrossRef
EJ Piovesan, MC Lange, LC Werneck, PA Kowacs & AL Engelhorn. (2001) Cluster-like headache. A case secondary to the subclavian steal phenomenon. Cephalalgia 21:8, 850–851

J. Ulfberg, N. Carter, M. Talbäck, C. Edling. (1996) Headache, snoring and sleep apnoea. Journal of Neurology 243:9, 621

-Dennis-

Title: Re: sleep apnea or sleep study
Post by beachmusic on Mar 1^st, 2008, 9:01am

Very Interesting, tyvm for that info Dennis.

Title: Re: sleep apnea or sleep study
Post by brewcrew on Mar 1^st, 2008, 9:43am

Sleep study done - 2001

Immediately went on CPAP therapy. Has done wonders for my outlook and my feeling of restedness. Hasn't done a darn thing for the CH.

CPAP is NOT oxygen therapy. It is merely pressurized room air (same mix of gasses - oxygen, nitrogen, etc.). The pressure merely keeps your airway open so you don't end up waking yourself numerous times every night to reinitiate breathing.

Don't poo-poo the mask. I started out with a full face mask (covers nose and mouth). Quickly graduated to a nose-only mask, and now I use a nasal pillow system. You do get used to it, and it will certainly mean feeling more rested and ready to battle the beast. It could mean the difference between life and death. Go finish your sleep study.

Title: Re: sleep apnea or sleep study
Post by Grinner62 on Mar 1^st, 2008, 12:08pm

I'm 46, diagnosed with episodic CH when I was 28. Finally got imitrex last Spring at the end of the worst cycle I'd ever had. I only got to abort two headaches before the cyle ended.

Last summer my neuro sent me for a sleep study. Yep, apnea. O2 sat got down to 84%, no REM at all. Basically, sleep deprivation every day. I believe that extra weight made it worse, but I had sleep problems before I retired from the Air Force and was in shape. Now my shape is a little more round than I prefer.

I had been shadowing 1-2 daily since my episode last Spring, wondering if I was going chronic.

CPAP didn't affect the shadows at all. Having said that, get the study done! The titration portion of the sleep study only lasted a couple hours, but I woke more rested than I had in decades. I've lost about 35 pounds in 6 months by doing nothing more than sleeping with an octopus stuck to my face. More energy during the day, better concentration, feel better in general and about life. Sometimes I even remember why I went into the other room!

In October, Neuro gave me a sample of provigil (Modanifil) for the sleep apnea (insurance required verified use of CPAP to get Provigil for apnea). Wow, between the CPAP and the Provigil I feel like I'm finally awake after 20 years. The shadows went away the day I started the Provigil.

Over the past month or so I have had a few hits. One started as soon as I laid down in bed. Started putting the CPAP on and had to rip it off right away. Not enough air through just one side. O2 off and on for the next 4 hours kept the beast at bay (Thanks everyone here, I finally got a 15 lpm regulator, that was the first time O2 worked for me).

I don't believe that this would be "wasted time". For me, the sleep deprivation during cycles makes it that much harder to recover and function between headaches. If, of course, you can call waiting for the next hit functioning...

Mike

Title: Re: sleep apnea or sleep study
Post by beachmusic on Mar 1^st, 2008, 12:23pm

Ohhhhh I am definitely convinced!!!! You guys got me on this one. I will be going back and will let everyone know the results. But please keep the info coming.

Title: Re: sleep apnea or sleep study
Post by jace77 on Mar 1^st, 2008, 8:46pm

did a sleep study and yep, sleep apnea, our neuro gave us an article and it said that it was common in CH, written by Goadsby I believe, but a good article It is hard to get used to, have to try to endure it a little at a time for longer periods, also sleep on an incline, actually more like almost sitting up which has helped ALOT. Feel much more rested in the morning and don't feel like a afternoon nap is needed.

Title: Re: sleep apnea or sleep study
Post by brewcrew on Mar 2^nd, 2008, 12:18am

on 03/01/08 at 20:46:20, jace77 wrote:

It is hard to get used to, have to try to endure it a little at a time for longer periods, also sleep on an incline, actually more like almost sitting up which has helped ALOT. Feel much more rested in the morning and don't feel like a afternoon nap is needed.

Not true. Depends on the individual. I was completely okay with the mask the first night.

Some people just get used to it faster than others. If you don't at first, keep at it.

Title: Re: sleep apnea or sleep study
Post by mudplugga on Mar 2^nd, 2008, 8:03pm

I haven't been here for a while, luckily I haven't needed to.

But I've got a cluster starting again and I also have aponea and use a CPAP machine

I'm 54 and have been a bad snorer since I was a boy, I went to boarding school so it was noticed!
I was diagnosed about 10 years ago and have used the CPAP every day since then, and the quality of my life has improved immensely. But I can't see a link to my CH.

My CH started about 25 years ago and was chronic for about 15 to 17 years, I can't remember dates, and then became periodic - generally annually at about February to April.

I never have night CH since I went periodic, but I did when chronic, and that was prior to using the CPAP.

If there is a link then it's possibly down to the fact that the CPAP helps with oxygen levels during sleep and the residual effect lasts throughout the day until early evening when the periodic CH occurs? ( I know it's not an 'oxygen machine', but it does raise oxygen levels )
Or, because I feel better due to getting proper sleep, then I'm somehow more resistant to CH and the chronic CH is alleviated?

Lloydy

Title: Re: sleep apnea or sleep study
Post by brewcrew on Mar 2^nd, 2008, 9:11pm

on 03/02/08 at 20:03:40, mudplugga wrote:

If there is a link then it's possibly down to the fact that the CPAP helps with oxygen levels during sleep and the residual effect lasts throughout the day until early evening when the periodic CH occurs? ( I know it's not an 'oxygen machine', but it does raise oxygen levels )

You're absolutely right, Lloyd. When your body stops breathing for 10 seconds or more hundreds of times a night, your O2 levels drop WAY below what's healthy. Your pulse/ox level should be 97-100%, and people with severe apnea can have their levels drop below 80%. Not good.

Title: Re: sleep apnea or sleep study
Post by gore2424 on Mar 6^th, 2008, 12:22am

Finnally after 4 months 5 different nites at two different hospitals I drove over 60 miles to the VA hospital and got my CPAP machine I would of bitched BUT it only cost me $15.00 total for all of it so only have had it two nites still trying to get it right my first test nite the nuero said I stopped breathing 64.5 times an hour thats less than 1 minute every hour the second time I sleept with machine the next day I had so much energy but still had h/a so time will tell if I will be more rested and less naps a day Terry

Title: Re: sleep apnea or sleep study
Post by LeeS on Mar 6^th, 2008, 5:38am

This is hot off the press in this respect (not sure if CH is mentioned though):

Quote:

Obstructive Sleep Apnea Common in Patients With Refractory Chronic Headache

NEW YORK (Reuters Health) Feb 26 - Refractory chronic headache is associated with obstructive sleep apnea (OSA), and C-PAP may not be the answer, according to a report in the February issue of Cephalalgia.

"OSA is present in one out of three snoring patients suffering from chronic refractory headaches," Dr. Dimos D. Mitsikostas from Athens Naval Hospital, Greece told Reuters Health. "Continuous positive airway pressure (C-PAP) treatment alone may not improve headaches, but additional investigation in a controlled design is required."

Full story here, but you may have to register first:

http://www.medscape.com/viewarticle/570679?src=mp

-Lee

Title: Re: sleep apnea or sleep study
Post by raven4 on Mar 14^th, 2008, 8:34pm

I had my first sleep study done in 1999 and went on CPAP. Never had a headache before in my life. Headaches started in 2000. I thought there was a correlation at first, but I have tried going through a cycle with CPAP and without - no affect.

That being said, had my second sleep study done 6 months ago - got the nasal pillow mask - it's great - I won't sleep without it.

Title: Re: sleep apnea or sleep study
Post by MR_JESTER on Mar 21^st, 2008, 9:19am

Good morning,

I also have sleep apnea. I have been on a CPAP for 2yrs @ 12cm H20. I have researched all of the info regarding a link between SA and CH. I was getting CH long before the SA developed.

I'm not convinced of the link, but I'm only one, and there may be a definate link for others.

Title: Re: sleep apnea or sleep study
Post by Sandy_C on Mar 21^st, 2008, 12:20pm

on 03/02/08 at 21:11:57, brewcrew wrote:

Darn, Brew! I don't have SA, but from what you said, I'm scared for my husband, because I know he has SA.

I consider myself being one of the lucky clusterheads who rarely gets hit at night. My hits have always been in the evenings, midday (2:00 or so) and with the last cycle mid mornings. I do wake up frequently during the night from other causes (leg pain, crap at work, kids, etc).

He is a heavy snorer, which I can sleep right through it. But he is also a heavy breather at night. This is one of the things that keeps me awake at night.

I listen to him breathe, and then it stops - cold, and I'm wide awake waiting for that huge intake of breath from him. He doesn't smoke, doesn't have CH, is a little overweight but very active playing tennis a minimum of three times a week. He does imbibe in maybe a beer or two more than he should, but not to excess. But this nighttime "not breathing" stuff keeps ME awake.

Since I know I will be awake anyway, I'm going to start counting the seconds when he is not breathing. He doesn't do this 100 times a night, because eventually, after a few hours, he does go in to a nice quiet sleep. So maybe he's not "severe", but is this something he should be having checked?

Sandy

Title: Re: sleep apnea or sleep study
Post by brewcrew on Mar 21^st, 2008, 4:56pm

If he won't do the wise thing and have a sleep study done, there is a next best thing. Apparently they have a product now called a sleep strip that can be purchased from sleep centers and it will diagnose sleep apnea. You should look into it.

I can't tell you the difference it has made in my life knowing that I have it and successfully treating it.

Title: Re: sleep apnea or sleep study
Post by mudplugga on Mar 21^st, 2008, 7:42pm

I last posted in this thread on the 8th March and said this -

" I never have night CH since I went periodic, but I did when chronic, and that was prior to using the CPAP. "

Which now turns out to be untrue! :-[ This week I've had a few night ch in addition to the daytime ones. This cluster is different to previous because I' now getting many more ch but generally sub Kip 7 whereas previous clusters were generally one screamer a day, in the evening.

This is the first year I've had o2 and I'm also using kudzu, good reports on both so far.

And along comes Brewcrew with this -

You're absolutely right, Lloyd. When your body stops breathing for 10 seconds or more hundreds of times a night, your O2 levels drop WAY below what's healthy. Your pulse/ox level should be 97-100%, and people with severe apnea can have their levels drop below 80%. Not good.

that reinforces my suspicions.

I've got a CPAP that has the pressure control on the outside of the machine so It's easy to wind it up a bit, which I'll try tonight.
I know it's air, but it might be a bit of help? And it's only what I do if I'm on holiday and staying somewhere that is higher altitude than the hole in the ground I live in. ;)