CH and Sleep Apnea...have you heard???


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Posted by Teviah Sachs (170.140.8.212) on April 21, 2001 at 12:42:53:

In Reply to: Sleep Study got ugly posted by Ed on April 21, 2001 at 00:26:28:

I have never been hooked up...and I am new to this site, but I saw an interesting article about CH and sleep apnea...is this why you went in??

Do you sleep on your back...cause thats when apnea happens. Epiglottis closes over your esophagus and so you stop breathing...depriving your brain of oxygen and maybe bringing on an attack. heres the article...something to talk to your doc about if you haven't already.

>>Sleep Disordered Breathing Common in Cluster Headache Patients
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WESTPORT, Jun 28 (Reuters Health) - Sleep disordered breathing occurs in the majority of patients with cluster headache, according to a report published in the June 27th issue of Neurology.

Dr. Ronald D. Chervin and colleagues from the University of Michigan, in Ann Arbor, performed polysomnography on 25 patients (22 men, 3 women) with active and inactive cluster headache. Defining obstructive sleep apnea as five or more apneas or hypopneas per hour of sleep, the authors report that 20 patients (80%) qualified for the diagnosis.

Using a more conservative diagnostic threshold of 10 or more apneas/hypopneas per hour of sleep, the researchers would diagnose 11 subjects (44%) with obstructive sleep apnea.

Minimum oxygen saturation fell below 90% in 10 subjects, and maximum end-tidal carbon dioxide reached or exceeded 50 mm Hg in eight subjects, the report indicates. In every subject, esophageal pressures dropped below -10 cm water; in 16 subjects, pressures dropped below -20 cm water.

Active cluster headache was accompanied by higher maximum end-tidal carbon dioxide levels, the investigators note, but otherwise active and inactive cluster headache was not associated with significant differences in polysomnographic variables.

Subjects whose cluster headache was more likely to occur during the first half of the night showed lower minimum oxygen saturations than did other subjects, even after adjustment for esophageal pressure differences, according to the report.

None of the subjects had a prior diagnosis of sleep disordered breathing, prompting the authors to conclude that "clinicians should have a high index of suspicion for undiagnosed sleep disordered breathing in their patients with cluster headache." They add, "Identification of sleep disordered breathing is important because treatment may reduce associated morbidity and mortality, including comorbid cluster headache."

"Patients with cluster headache particularly those who are awakened by headaches or have headaches when they awake should be asked the usual screening questions for sleep apnea. Most patients whose sleep apnea is treated experience great relief from their cluster headaches," Dr. Chervin said in an interview with Reuters Health.

"About 80% of people with sleep apnea do not know they have it, so you have to ask the right questions. Do they snore? Are they excessively sleepy during the day? Do they have obesity or hypertension? And so on. If there's any doubt about the diagnosis, it's probably worth doing formal sleep studies in the right patients."

Neurology 2000;54:2302-2306





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