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        New Message Board Archives >> Medications, Treatments, Therapies 2003 >> CH and Sleep Apnea
        
(Message started by: brewcrew on Jan 12^th, 2003, 7:03pm)

Title: CH and Sleep Apnea
Post by brewcrew on Jan 12^th, 2003, 7:03pm

This is my first post - been lurking for years. CH sufferer for over ten years, usually 3-4 clusters per year, each lasting 6-8 weeks. Best propyllactic treatment for me is Verapamil 240 mg 2x per day, and the best abortive is Maxalt and oxygen.

I've recently been diagnosed with severe sleep apnea, and have just started therapy on a Continuous Positive Airway Pressure (CPAP) machine while sleeping. I'm wondering if anyone else here has been diagnosed with same and if you've noticed any connection between the two.

My theory is that as the blood oxygen level drops, on comes the beast. Hopefully with the CPAP, blood oxygen level stays up in the 90% range and keeps the beast sleeping.

I'd be interested to hear from others who might have some thoughts on the subject. PFDAN to all.

Title: Re: CH and Sleep Apnea
Post by Mark C on Jan 12^th, 2003, 10:14pm

Screwed up sleep seems to be a common trait to us Clusterheads......
http://www.clusterheadaches.org/library/general/apnea.htm

Title: Re: CH and Sleep Apnea
Post by Bob P on Jan 13^th, 2003, 9:00am

Why do my attacks come in cycles if I have apnea all the time?

Why do I get daytime attacks if the apnea only effects my O2 level while I'm sleeping?

Why do my nightime attacks always come 1 1/2 hours after I fall asleep instead of all through the night?

These are a couple of questions that I asked the doc who did the study in the OUCH Library. His response was that ch is very complicated are there are probably a number of factors involved. He was not saying that apnea causes clusters.

I think you'll find the nightime attacks are more in line with REM sleep then they are with apnea.

Title: Re: CH and Sleep Apnea
Post by brewcrew on Jan 13^th, 2003, 10:45am

These are some of the same questions I have had since finding out I've got Obstructive Sleep Apnea. Like I said, it's a new diagnosis (I've only been on the CPAP for 3 nights so far). I think I will print and fax the study synopses to my neuro and chat with him about it next time I see him. Thanks for the link (I had done a search of the site on "apnea" and came up with zilch).

Thanks again.

Title: Re: CH and Sleep Apnea
Post by firebrix on Jan 13^th, 2003, 5:17pm

Welcome brewcrew!
Sorry to hear you are in pain but glad you found this site. It, and OUCH have the best information around and we all learn heaps here. No need to lurk tho' - c'mon in and join the fun.

I agree with Bob on this one - CH is complicated and what may work for one doesn't work for others; likewise, some suffer sleep apnea - others don't. Put your specs on and read all you can on the archives and search; the worst that'll happen is you'll be able to understand more of your condition and be able to understand what the neuros tell you. Have you sen a neuro?
Good luck with the CPAP. Hope its your magic bullet
PFDAN
firebrix

Title: Re: CH and Sleep Apnea
Post by LisaP on Jan 13^th, 2003, 6:16pm

My husband also uses a CPAP machine - he does not have as many headaches at night since he started using it. I spend much less time on the couch since it has stopped the snoring and he wakes up rested which as you will find is the biggest benefit. I hope it works for your headaches - but the other health benefits are also worth using it. Good luck!

Title: Re: CH and Sleep Apnea
Post by bRathbone on Jan 14^th, 2003, 12:47am

To answer the questions like "if sleep apnea is the cause, why are they daytime headaches, etc.", my guess is that the cluster period is a time of vulnerability where a bunch of things, including apnea, can cause clusters. For example, this week I've triggered into three #10 headaches just be eating, one time a mouthful of grapes, and also by drinking a glass of ice water and touching my forehead with an ice pack.

I'm chronic, but most times of the year don't get #10's. Normally I get some mild pain after eating, but during the cluster-within-a-cluster times like now, a meal can turn into a head-banging #10. So maybe apnea is the same way.

Oxygen or lack thereof does seem to be a part of the picture, as shown by its use to abort headaches. Some people have reported exercise can abort a headache, and in my case I can often cut the pain level of a moderate #7 headache near zero just by deep, slow breathing (air not oxygen).

Title: Re: CH and Sleep Apnea
Post by Marc on Jan 14^th, 2003, 2:44am

Too bad Ted isn't online for this thread ;)

Title: Re: CH and Sleep Apnea
Post by Bob P on Jan 14^th, 2003, 9:22am

Have to disagree with the"lack of oxygen seems to be part of the picture" statement. That's like saying a lack of ergot or a lack or triptan or a lack of serotonin is part of the picture because they can be used to abort an attack.

Just because a substance reverses what causes the pain does not mean that a lack of that substance is what caused the pain to start with.

Title: Re: CH and Sleep Apnea
Post by brewcrew on Jan 14^th, 2003, 10:06am

Bob P - Here's the part of it that does seem to make sense, though. When blood O2 levels drop, the circulatory system's response is to dialate the vessels. Cells need more O2, increase the size of the pipeline. If O2 levels are maintained in the 90% range, blood vessels don't have to dialate in order to deliver the same amount of O2.

I'm not a doctor (and I don't play one on TV, but I did stay at a Holiday Inn Express last night). Wait - got carried away for a minute. Since the physiology of CH seems to be first an initial contraction of the artery followed by a dialation, one would think that this "on again, off again" cycle thing could be positively affected by keeping O2 levels at or near normal.

I learned a few things about my own physiology via the sleep study. My normal waking blood O2 level is 97-98%, which is very good. During my sleep study, my blood O2 levels dropped into the low 80's. I was waking up to initiate breathing an average of 88 times per hour without even being aware of it. Spent the majority of the time in stage 2 sleep, a little bit in low wave sleep, and NO time in REM sleep. No wonder I'm grumpy on top of all the rest of it!

I just don't know how this whole apnea thing will affect the headaches. Last night was my 4th night on the CPAP and I woke up 90 minutes after going to bed with about a kip 7. Ended up switching masks twice (O2 and the CPAP) and taking some Maxalt. HA subsided within about 30 minutes. May need to start in on a Prednisone taper, which will stop the beast cold for me.

Thanks to all of you for making me feel welcome here, not making me feel like an idiot, and helping me feel like I'm not losing my mind. I appreciate all of you. :D

Title: Re: CH and Sleep Apnea
Post by Marc on Jan 15^th, 2003, 12:47am

Brew,

I'm interested in something you said:

"Since the physiology of CH seems to be first an initial contraction of the artery followed by a dialation........."

Where did this info come from?

Thanks,

Marc

Title: Re: CH and Sleep Apnea
Post by Bob P on Jan 15^th, 2003, 9:52am

Marc,

I've seen that statement in articles before. Unfortunately, they were migraine articles. I don't recall seeing that in cluster articles.

Title: Re: CH and Sleep Apnea
Post by brewcrew on Jan 15^th, 2003, 10:20am

Marc - I seem to recall reading it in a study right after I was first diagnosed, but can't recall the author. I will attempt to locate in the literature I've saved.

Once you get to know me, you will know that I am the first one to tell folks to correct me if I'm wrong. And that I better be able to back up what I say. With that in mind, I am prepared to say that I may not be able to substantiate it. It is something I recall remembering about my initial research when I was first diagnosed, but I'll let you know what I find.

bc

Title: Re: CH and Sleep Apnea
Post by Ueli on Jan 15^th, 2003, 11:45am

Marc, BobP,
if I remember right the contraction of the vessels is what causes the M. aura phase, and that's why they say not to take the triptans preventatively for M.

Title: Re: CH and Sleep Apnea
Post by Marc on Jan 15^th, 2003, 12:41pm

Bob P and Ueli,

Thanks for the info.

Brew,

No problem. I wasn't intending challenge your integrity, I just hadn't heard that one before so I asked. ;D

Marc

Title: Re: CH and Sleep Apnea
Post by brewcrew on Jan 15^th, 2003, 12:56pm

Marc - I looked in my printed material and couldn't find anything. I then did a Google search and spent a little time looking, and also couldn't find anything.

Next time I'm visiting my neuro - who is fantastic and brilliant - I will ask and report back.

No problem. I didn't feel like you were challenging my integrity. If I'm going to state something I believe to be true, I should be prepared to back it up. ;)