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Sleep disordered breathing in patients with cluster headache
R D Chervin1, S N Zallek, X Lin
1Sleep Disorders Center, Department of Neurology, University of Michigan, Ann Arbor 48109-0117, USA. chervin@umich.edu
Neurology
|July 6, 2000
Summary
Sleep disordered breathing (SDB) is common in cluster headache (CH) patients, often occurring during sleep. This suggests SDB may trigger CH attacks, warranting evaluation in affected individuals.
Area of Science:
- Neurology
- Sleep Medicine
- Pulmonology
Background:
- Cluster headache (CH) frequently occurs during sleep.
- Previous research suggests sleep disordered breathing (SDB) symptoms predict CH occurrence in early night.
- This indicates unrecognized SDB may trigger CH in some patients.
Purpose of the Study:
- To investigate the prevalence of occult sleep disordered breathing (SDB) in patients with cluster headache (CH).
Main Methods:
- Polysomnography was conducted on 25 adults with CH, without prior sleep complaints.
- Standard sleep monitoring was augmented with end-tidal carbon dioxide and esophageal pressure measurements.
- Data analysis focused on apnea-hypopnea index, oxygen saturation, esophageal pressure, and end-tidal carbon dioxide levels.
Main Results:
- A high prevalence of SDB was observed, with 80% of subjects exhibiting an apnea-hypopnea index >5 per hour.
- Ten subjects experienced oxygen saturation below 90%, and eight had elevated end-tidal carbon dioxide levels (≥50 mm Hg).
- Active CH patients showed significantly higher end-tidal carbon dioxide levels compared to inactive CH patients (p = 0.0007).
- Greater oxygen desaturation correlated with CH occurring in the first half of the night (p = 0.008).
Conclusions:
- The majority of cluster headache patients exhibit sleep disordered breathing.
- Clinicians should consider SDB as a potential contributing factor in CH evaluation.
- Identifying and managing SDB may offer a novel therapeutic approach for cluster headache management.