wmjohn76012 wrote on Feb 7^th, 2009 at 8:43am:


Links would be helpful and most appreciated, if available.

Best wishes,

George

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 

--------------------------------------------------------------------------------

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."

 

See new message, "sleep apnea & cluster", in this section.

wmjohn76012 wrote on Feb 7^th, 2009 at 8:43am:


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.

wmjohn76012 wrote on Feb 7^th, 2009 at 8:43am:


Agreed.

wmjohn76012 wrote on Feb 7^th, 2009 at 8:43am:


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.  

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........

Joe

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. 

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......

Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or

UnderTheRadar wrote on Feb 10^th, 2009 at 6:46pm:


Who do ya think invented government??

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