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        New Message Board Archives >> Medications, Treatments, Therapies 2004 >> A kinder, gentler, CH treatment.
        
(Message started by: CJohnson on Jan 6th, 2004, 12:31pm)
Title: A kinder, gentler, CH treatment.
Post by CJohnson on Jan 6th, 2004, 12:31pm
 If, in fact, circadian rhythm dysfunction is at the root of CH and proper manipulation of the circadian rhythm can prevent or halt cycles, then the following seems pretty interesting.

Journal of Neuroendocrinology
Volume 15 Issue 4 Page 438  - April 2003
doi:10.1046/j.1365-2826.2003.01006.x
Optimization of Light and Melatonin to Phase-Shift Human Circadian Rhythms

Both light and melatonin, appropriately timed, have been shown to phase-shift human circadian rhythms. In addition, both light and melatonin have acute physiological and behavioural effects. Depending on the dose, melatonin can reduce core body temperature and induce sleepiness. Conversely, light at night increases body temperature and enhances alertness and performance. The acute and phase-shifting effects of light and melatonin have justified their investigation and use in the treatment of circadian rhythm sleep disorders. Melatonin is the treatment of choice for blind people with non-24 h sleep/wake disorder. Current research is directed towards optimizing these therapies with respect to time of administration, dose and formulation of melatonin, intensity, duration and spectral composition of light. Our studies in totally blind people with non-24 h sleep/wake disorder have shown that, in addition to improving sleep, daily administration of melatonin can entrain their free-running circadian rhythms. The ability of melatonin to entrain free-running rhythms depends, in part, on the time of melatonin administration relative to the subject's circadian phase. Subjects who were entrained by melatonin began their treatment in the phase advance portion (CT 6-18) of the published melatonin phase-response curves (PRCs), whereas those who failed to entrain began their melatonin treatment in the delay portion of the PRC. Whether the effect of light on the human circadian axis can be optimized by altering its spectral composition has been investigated. Recently, it was demonstrated that light-induced melatonin suppression in humans is sensitive to short wavelength light (420-480 nm; max approximately 460 nm), a response very different to the classical scotopic and photopic visual systems. Whether other nonvisual light responses (e.g. circadian phase resetting) show a similar spectral sensitivity is currently being studied.

http://www.blackwell-synergy.com/links/doi/10.1046/j.1365-2826.2003.01006.x/abs/

PFDANs
-Curtis
Title: Re: A kinder, gentler, CH treatment.
Post by floridian on Jan 6th, 2004, 1:12pm
Melatonin and light therapy - its all in the timing!

Any body know which way their clocks switch in cycle?  Do you run early or late?  And exactly when should light or melatonin be adminstered to normalize the rhythms?  Given at the wrong time, light or melatonin could concievably make things worse.

I'm guessing my clock runs ahead, as I wake up earlier and earlier right before a cycle.


This abstract found that heart rate circadian cycles were shifted 1 hour (but no word on which direction!!) in the active phase of clusters.  


Clin Auton Res. 1993 Oct;3(5):291-8.  Imbalance of heart rate regulation in cluster headache as based on continuous 24-h recordings.  Micieli G, Cavallini A, Bosone D, Tassorelli C, Barzizza F, Rossi F, Nappi G.

This abstract also mentions a shift in circadian cycles, but no word on which direction or how much.

Headache. 2002 Feb;42(2):125-31.   Impaired circadian rhythmicity of nociceptive reflex threshold in cluster headache.   Nappi G, Sandrini G, Alfonsi E, Cecchini AP, Micieli G, Moglia A.
Title: Re: A kinder, gentler, CH treatment.
Post by violet on Jan 6th, 2004, 1:52pm
I recently moved from the west coast time to the east coast time, So i go to bed about 3-4 hours earlier than I used to, and now I'm having more clusters at night.  I wonder if there is a connection.
Vi
Title: Re: A kinder, gentler, CH treatment.
Post by ave on Jan 6th, 2004, 2:06pm

Quote:
If, in fact, circadian rhythm dysfunction is at the root of CH


Yessss.... no..... I have been circadial disfunctional all my life, as far as I can see. As a 5 yr. old, not sleeping, lying awake for hours - and the pattern never changes substantially over the years.

But I have not have had clusters all my life.

The best we can argue is predisposition,  I'll grant you that.
Title: Re: A kinder, gentler, CH treatment.
Post by CJohnson on Jan 6th, 2004, 3:05pm

on 01/06/04 at 14:06:22, ave wrote:
The best we can argue is predisposition,  I'll grant you that.


I'll say. Its hard to find any literature about cluster headaches which doesn't point to circadian pacemaking mechanisms, or some aspect thereof, as being key aspects of CH.

PFDANs
-Curtis
Title: Re: A kinder, gentler, CH treatment.
Post by BillyJ. on Jan 7th, 2004, 1:34am
Just my opinion but,I think that heart rate,blood presure
sleep cycles,mood cycles,mood disorders,just to name a
few,are all controlled by the hypothalimus.
 I think that if a study was done of CHers of all the things
controlled by the clock that you would find a very high %
of multiple abnormallitties.
  This means (to me) that they are co-occurrances and
treating one is not going to treat the others.I feal that
they are all controlled by the 'clock'(at least thats the theory) So what controls the clock?
Title: Re: A kinder, gentler, CH treatment.
Post by Gena on Jan 7th, 2004, 10:20am
This is a great post really got me thinking :-/

I have spring/summer clusters - days are longer
and find myself PF in the winter - days are shorter

I tend to get more sleep in the winter because (well besides being PF) it is dark sooner, so I go to bed around 9, in the summer I am lucky if I am in bed at midnight.

maybe I sould live in a cave  ::)

Gena
Title: Re: A kinder, gentler, CH treatment.
Post by ozzman on Jan 7th, 2004, 10:26am
Regarding your question Floridian, in my case my clock seem to run faster as you explain, I wape up earlier and earlier right before my cycle, but at the same time I seem to go to bed later and later??? My mood also suffers, I become quick tempered and now that my attacks have noticeably decreases I noticed that the day of the attack my temper runs hot for no reason at all...

Ozzy
Title: Re: A kinder, gentler, CH treatment.
Post by floridian on Jan 7th, 2004, 11:44am
Ozzman,

I also go to bed later and later, but get up earlier and earlier.  Almost manic.  The first few years, I thought it was great - more energy, more time to do things.  Now I recognize it as a warning of the beast.
Title: Re: A kinder, gentler, CH treatment.
Post by CJohnson on Jan 7th, 2004, 12:19pm
 I have not recognized this pattern in myself. I love to sleep and have no trouble sleeping (except for night time attacks). I go to bed and get up around the same time all year long. My headaches are always in the winter months and most of my attacks occur at night.

PFDANs
-Curtis
Title: Re: A kinder, gentler, CH treatment.
Post by Gena on Jan 7th, 2004, 2:30pm
So that still leaves the ? why do some of us get hit in the Summer and some git hit in the Winter.

And does hot and cold have anything to do with it or is it the amount of light verses dark?

Just more ?

Gena
Title: Re: A kinder, gentler, CH treatment.
Post by CJohnson on Jan 7th, 2004, 3:01pm
 Could be an abnormal hypothalamus. A certain kind of abnormality in the hypothalamus could be responsible for cluster headaches in part or in whole. There could be variations in that abnormality or different effects from the way that abnormality interacts with other aspects of a persons physiology to explain the differences between different clusterheads. The point is if a physically messed up hypothalamus us screwing up the circadian rhythms and putting us into a pain state, perhaps the circadian rhythm (or aspects of it) can be artificially phase shifted to put us into a non-pain state.

Abnormalities in the Hypothalamus
Evidence now strongly suggests that abnormalities in the hypothalamus, a complex structure located deep in the brain, may play a major role in cluster headaches. Advanced imaging techniques have revealed that a specific area in the hypothalamus is asymmetrical in these patients and is activated during a cluster headache attack.

The hypothalamus is involved in the regulation of many important chemicals and nerve pathways, including the following:

Nerve clusters that regulate the body's biologic rhythms (its circadian rhythms).
Serotonin and norepinephrine. These are neurotransmitters (chemical messengers in the brain) that are involved with well being and appetite.
Cortisol (stress hormones).
Melatonin (a hormone related to the body's response to light and dark).
Beta-endorphins (substances that modulate pain).

http://www.healthandage.com/Home/gm=6!gid6=9903

PFDANs
-Curtis
Title: Re: A kinder, gentler, CH treatment.
Post by daver on Jan 7th, 2004, 3:58pm

on 01/07/04 at 14:30:25, Gena wrote:
So that still leaves the ? why do some of us get hit in the Summer and some git hit in the Winter.


I get hit, like clock-work, end of December, then again at the end of August.

Not sure how that works into the theories...just adding my 2 cents  :)

d.
Title: Re: A kinder, gentler, CH treatment.
Post by Bob P on Jan 8th, 2004, 10:12am
A link to the OUCH Library:

http://www.clusterheadaches.org/library/hypothalamus/index.htm

The hypothalamus is indeed a major suspect.


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