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Cluster Headache Help and Support >> Cluster Headache Specific >> Medical Opinions
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Message started by wmjohn76012 on Feb 7th, 2009 at 8:43am

Title: Medical Opinions
Post by wmjohn76012 on Feb 7th, 2009 at 8:43am
I think it important to really read the data that is out there and not just bits and pieces before comming on here and posting like a medical expert on this subject. This is a place to find out what you can about the issue and condition. To respond to peoples posts with condecending nonfounded medical opinions as though they are facts is not only rude but, could actually do more harm than good. I would like to know if anyone on here has actually read any of the studies that have been conducted out there and if they gave you a better understadning on your condition? I am toying with the idea of the correlation of sleep apnea and cluster heads. I know that the two seem unrelated but, there are convincing studies by actual experts that suggest there may be a connection. In otherwords people that have sleep apnea seem to most always have bouts of cluster headaches. Now ofcourse the studies piont out that many Cluster Heads do not have sleep apnea. The seratonin connection is very interesting as well as the H2O connection with the two conditions. ;)

Title: Re: Medical Opinions
Post by George on Feb 7th, 2009 at 8:49am

wmjohn76012 wrote on Feb 7th, 2009 at 8:43am:
I am toying with the idea of the correlation of sleep apnea and cluster heads. I know that the two seem unrelated but, there are convincing studies by actual experts that suggest there may be a connection.


Links would be helpful and most appreciated, if available.

Best wishes,

George

Title: Re: Medical Opinions
Post by Marc on Feb 7th, 2009 at 9:12am

wmjohn76012 wrote on Feb 7th, 2009 at 8:43am:
................ In otherwords people that have sleep apnea seem to most always have bouts of cluster headaches............................


Based on your initial comments, I would love to see the studies you are referencing because I haven't seen this yet.

Marc

Title: Re: Medical Opinions
Post by Bob_Johnson on Feb 7th, 2009 at 9:19am
Your general comment about not pushing personal views as medical fact is well taken. But none of us have the training to evaluate medical studies which we often post and, as you are aware, the evolving nature of research is such that, even if we could evaluate material, in an area like CH, many of the findings are tentative.
=========
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.

Publication Types:
Comparative Study

PMID: 12716345 [PubMed]
--------------
Headache. 2004 Jun;44(6):607-10.  
 
Obstructive sleep apnea and cluster headache.

Graff-Radford SB, Newman A.

The Pain Center, Cedars Sinai Medical Center and UCLA School of Dentistry, Los Angeles, CA 90048, USA.

A patient with cluster headache often wakes from sleep. The relationship to sleep apnea has been described. This study sought to confirm the relationship cluster may have with sleep apnea. METHODS: Thirty-nine consecutive patients diagnosed with episodic cluster headache according to the International Headache Society (IHS) criteria were sent for polysomnographic studies. All patients were in an active phase when they were in the study. Patients were told of the proposed relationship and were allowed to choose a sleep laboratory close to their home. RESULTS: Thirty-one patients with episodic cluster headache completed an overnight polysomnographic study. Twenty-three were male and eight female. The average age was 51 years (range 33 to 78 years). The average weight was 173 pounds (range 117 to 260 pounds). A total of 80.64% had sleep apnea (25/31). Average respiratory depression index (RDI) was 19.0 (SD 14.6) with 6 patients having no apnea, 10 having mild, 11 having moderate, and 4 having severe apnea (RDI < 5 = none; RDI 5 to 20 mild; RDI 20 to 40 moderate; RDI > 40 severe). Oxygen saturation decreased on average to 88.4% SD 4.5. Sleep efficiency was 76.2% (SD 13.4). CONCLUSIONS: The data closely approximate those of Chervin et al, where 80% had RDI > 5.

THE RELATIONSHIP SLEEP APNEA HAS IN THE PERPETUATION OR PRECIPITATION OF CLUSTER HEADACHE IS STILL TO BE DETERMINED. THERE ARE SOME REPORTS THAT TREATMENT STOPS THE CLUSTER BUT THERE IS NO PROSPECTIVE STUDY. THE HIGH INCIDENCE (80.64%) SEEN IN THIS POPULATION SUGGESTS THE CLUSTER PATIENT SHOULD RECEIVE A SLEEP EVALUATION AND PERHAPS INTERVENTION WITH CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) OR AN APPROPRIATE DENTAL DEVICE.

PMID: 15186306  
----------------
Ch, sleep apnea and heart disease
« on: Jun 15th, 2005, 11:00am »  Quote  Modify  Remove  

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There have been a few reports posted here about the substantial % of CH folks who have sleep apnea and its association with CH.

Here, we have a report adding more evidence to the warnings that sleep apnea can both lead to heart disease and increase the risks in folks who have already been diagnosed with heart disease.  

Although "positive airway pressure" therapy may be difficult to live with, this study indicates why continuing it with has some significiant benefits.
-------------
 
 
Sleep Apnea Therapy Improves Cardiovascular Outcomes


By Will Boggs, MD

NEW YORK (Reuters Health) Jun 13 - Nasal continuous positive airway pressure (CPAP) therapy lowers cardiovascular death rates in patients with obstructive sleep apnea (OSA), according to a report in the June issue of Chest.

"We believe that these findings provide a strong basis for physicians to encourage compliance with CPAP in patients with OSA, particularly in severe cases, based on the strong likelihood that such patients, if untreated, are at substantially higher risk of cardiovascular complications," Dr. Walter T. McNicholas from St. Vincent's University Hospital, Dublin told Reuters Health.

Dr. McNicholas and colleagues compared the cardiovascular outcomes over more than 7 years of 107 patients with OSA who continued to receive CPAP therapy with 61 similar patients who had quit therapy.

A significantly smaller proportion of patients continuing CPAP therapy experienced cardiovascular death (1.9%) than did patients who discontinued CPAP (14.8%), the authors report.

Most deaths in the untreated group were during the night or early morning hours, the investigators note, and four of the nine deaths were sudden and unexpected. Only two CPAP-treated patients died of cardiovascular causes during follow-up.

There were also significantly more cardiovascular events (death and new cardiovascular disease combined) in the untreated patients (31%) than in the CPAP-treated patients (18%), the results indicate.

Among the patients who died, there were no differences in age at diagnosis, body mass index, or apnea/hypopnea index, the researchers note.

The two groups did not differ in body mass index (which did not change significantly), subsequent otolaryngologic surgery, or smoking behavior during follow-up, the report indicates.

"OSA is a substantial contributing factor to cardiovascular disease, and cardiologists should be aware of this association, particularly since our data indicate substantial cardiovascular benefit from treatment of the disorder," Dr. McNicholas concluded.

"We are currently engaged in an extensive translational project examining the relationship between intermittent hypoxia (which is characteristic of OSA) and the activation of inflammatory pathways that predispose to atherogenesis," Dr. McNicholas explained. "These studies involve a cell culture model of intermittent hypoxia and also the measurement of various inflammatory and adaptive cytokines in patients with OSA."

 

Title: Re: Medical Opinions
Post by FramCire on Feb 7th, 2009 at 10:18am

wmjohn76012 wrote on Feb 7th, 2009 at 8:43am:
In otherwords people that have sleep apnea seem to most always have bouts of cluster headaches.


I think this is very much a false statement.  I know tons of people with apnea and very few have CH.  Even such a small sample set shows that this statement is likely false.

If you have a study, Id be interested in reading it.

Title: Re: Medical Opinions
Post by Bob_Johnson on Feb 7th, 2009 at 11:52am
See new message, "sleep apnea & cluster", in this section.

Title: Re: Medical Opinions
Post by Guiseppi on Feb 7th, 2009 at 4:49pm
I think you may have mis-interpreted the purpose of this board. We don't prescribe or administer meds to anyone. We tell people:

A whole bunch of us tried wrapping our heads in aluminum foil and snorting banana juice, and it didn't work. I wouldn't try that as a front line abortive.

A whole bunch of us get instant relief from huffing 02, I'd try that before the banana peel aluminum foil abortive.

In this manner, newbies get an idea of what is working for a large percentage of people with CH. This is material they can take back to their doctor, and under a doctors care, develop a treatment plan that gives them a higher percentage of relief.

When someone comes on the board and says he cured CH with something like a CPAP machine, we are quick to point out to the newbies that many of our sufferers have sleep apnea and use the machine, it seems to have no effect, positive or negative on their CH. While they may be the one in 10,000,000 that a CPAP machine would stop their CH, I feel it's more beneficial to give them the high percentage treatments first.

I am certainly not in the same league as a Bob Johnson in his ability to research, digest and post the studies he does. (All worth reading by the way). But that fact doesn't mean I'm not qualified to post as a sufferer who has found succesful methods to manage his CH.

Joe

Title: Re: Medical Opinions
Post by monty on Feb 7th, 2009 at 5:37pm

wmjohn76012 wrote on Feb 7th, 2009 at 8:43am:
... In otherwords people that have sleep apnea seem to most always have bouts of cluster headaches.


That is backwards.  Millions of people that have sleep apnea do not have cluster headaches. A very high percent of people with clusters do have apnea ... this indicates that apnea may be a contributing factor.  Given the fact that apnea is a dangerous condition (whether or not there are headaches), I suggest that anyone who has cluster headaches is a priority for getting a sleep study.

Title: Re: Medical Opinions
Post by BlueMeanie on Feb 7th, 2009 at 6:49pm

wmjohn76012 wrote on Feb 7th, 2009 at 8:43am:
I think it important to really read the data that is out there and not just bits and pieces before comming on here and posting like a medical expert on this subject.

I am toying with the idea of the correlation of sleep apnea and cluster heads. I know that the two seem unrelated but, there are convincing studies by actual experts that suggest there may be a connection. In otherwords people that have sleep apnea seem to most always have bouts of cluster headaches. ;)


Looks like you broke your own rules.

Title: Re: Medical Opinions
Post by Pinkfloyd on Feb 8th, 2009 at 4:36pm

wmjohn76012 wrote on Feb 7th, 2009 at 8:43am:
To respond to peoples posts with condecending nonfounded medical opinions as though they are facts is not only rude but, could actually do more harm than good.


Agreed.


wmjohn76012 wrote on Feb 7th, 2009 at 8:43am:
 very interesting as well as the H2O connection with the two conditions. ;)


Does the water X 3 treatment also work for sleep apnea?  ::)

Bobw
Who realizes that a simple typo isn't all that significant but in the context of this post was quite ironic, I thought.
Besides, over 100,000 people a year die in hospitals that shouldn't but do, because of medical mistakes such as prescription typos. So, they can be important.

P.P.S. Potter is the kinder and gentler one.  ;)


Title: Re: Medical Opinions
Post by Grinner62 on Feb 9th, 2009 at 9:49pm

Guiseppi wrote on Feb 7th, 2009 at 4:49pm:
A whole bunch of us tried wrapping our heads in aluminum foil and snorting banana juice, and it didn't work. I wouldn't try that as a front line abortive.

I missed that memo. I can still keep the hat to foil the black helicopters though?

Title: Re: Medical Opinions
Post by Guiseppi on Feb 9th, 2009 at 10:35pm
I can still keep the hat to foil the black helicopters though?

Dude...keep the foil hat on...ALWAYS  keep the foil hat on...the feds can't hear anythng you think........ :o

Joe ;)

Title: Re: Medical Opinions
Post by Brew on Feb 9th, 2009 at 10:38pm
But the shiny side has to be facing in.

Title: Re: Medical Opinions
Post by Jimi on Feb 9th, 2009 at 11:57pm
Now THAT is entirely untrue. Everyone that has been around for at LEAST 10 years knows that the shiny part has to be facing out.  ::)

Title: Re: Medical Opinions
Post by Brew on Feb 10th, 2009 at 7:21am
I thought I could sneak one by ya.

Title: Re: Medical Opinions
Post by Marc on Feb 10th, 2009 at 3:27pm
No such thing as too much protection, so mine is multi-layered with the shiny side reversed on each layer. Some things just aren’t worth taking a chance on......

Title: Re: Medical Opinions
Post by Brew on Feb 10th, 2009 at 3:36pm

Marc wrote on Feb 10th, 2009 at 3:27pm:
No such thing as too much protection, so mine is multi-layered with the shiny side reversed on each layer. Some things just aren’t worth taking a chance on......

Especially when it comes to the government stealing your essences.

Title: Re: Medical Opinions
Post by UnderTheRadar on Feb 10th, 2009 at 6:46pm
I thought only the Skexis stole essences!



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;D

Title: Re: Medical Opinions
Post by Guiseppi on Feb 10th, 2009 at 6:54pm
Thas messed up.... :o

Joe

Title: Re: Medical Opinions
Post by monty on Feb 10th, 2009 at 8:58pm

UnderTheRadar wrote on Feb 10th, 2009 at 6:46pm:
I thought only the Skexis stole essences!

;D


Who do ya think invented government??

I go for the laminate composite foils myself - more effective, more durable, quieter.  

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