Refractory chronic headache associated with obstructive sleep apnoea syndrome
D D Mitsikostas1, M Vikelis, A Viskos
1Athens Naval Hospital, Neurology Department, Athens, Greece. dmitsikostas@ath.forthnet.gr
Cephalalgia : an International Journal of Headache
|November 15, 2007
Summary
Chronic refractory headaches may be linked to obstructive sleep apnoea syndrome (OSAS). Polysomnography is recommended for patients with sleep-related headaches or snoring, especially middle-aged, overweight men. Continuous positive airway pressure (C-PAP) showed limited headache improvement.
Area of Science:
- Neurology
- Sleep Medicine
- Internal Medicine
Background:
- Chronic refractory headaches are a significant clinical challenge.
- Obstructive sleep apnoea syndrome (OSAS) is a prevalent condition often associated with various health issues.
- The comorbidity between chronic headache and OSAS requires further investigation.
Purpose of the Study:
- To investigate the prevalence and characteristics of obstructive sleep apnoea syndrome (OSAS) in patients with chronic refractory headaches.
- To assess the impact of continuous positive airway pressure (C-PAP) treatment on headache symptoms in patients with diagnosed OSAS.
Main Methods:
- Seventy-two patients with chronic refractory headaches, experiencing sleep-related headaches or snoring, underwent polysomnography.
- Patients diagnosed with OSAS (respiratory disturbance index > 10) were treated with C-PAP and followed for at least 6 months.
- Multivariate regression analysis was used to identify factors associated with OSAS.
Main Results:
- OSAS was identified in 29.2% of the study population (66.6% of men, 13.7% of women).
- Medication overuse headache and cluster headache were the most common headache types among OSAS patients.
- Age, male gender, and body mass index were significantly associated with OSAS.
- C-PAP treatment improved both OSAS and headache symptoms in approximately one-third of the patients.
Conclusions:
- A significant proportion of patients with chronic refractory headaches, particularly middle-aged, overweight men with sleep-related symptoms or snoring, have undiagnosed OSAS.
- Polysomnography should be considered for this patient group to identify potential OSAS.
- While C-PAP treatment can improve OSAS, its direct impact on headache relief is limited, warranting further research.
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