Sleep disorders
can cause insomnia (difficulty getting to sleep or staying asleep),
excessive daytime sleepiness, or unwanted
behavior in sleep. Sleep apnea is a syndrome of repeated episodes
of stopping breathing in sleep. While morning headaches are a
complaint of many patients with sleep apnea, many different sleep
disorders have been linked to morning headache. In people with
frequent headaches upon waking, sleep apnea should be considered,
but so should other causes of sleep disruption.
Obstructive
sleep apnea, due to collapse of the upper airway, is the most
common
type of apnea and the most commonly diagnosed
sleep disorder. It is typically associated with snoring and
often causes excessive daytime sleepiness. An episode of apnea
often
causes reduced blood oxygen level, increased blood pressure,
and brief awakening.
Treatment
of sleep apnea may help prevent headaches that awaken one from
sleep or occur first thing in
the morning. Most apnea
is easily treated. CPAP (continuous positive airway pressure)
provides pressurized air through a mask worn over the nose
during sleep, and almost always controls apnea. Weight loss
can also
help and sometimes cure apnea. Others may benefit from surgery
to remove the uvula and some of the soft palate at the back
of the throat, but this is only effective in fewer than half
of
patients. An oral appliance can be worn during sleep to reposition
the jaw forward. This treats some people with mild to moderate
sleep apnea, but is not generally effective in severe cases.
Since
low oxygen (such as at high altitude) can trigger cluster
headaches, and sleep apnea can cause low oxygen levels, some
have speculated that sleep apnea may trigger cluster headaches
in some people. A relationship between cluster headache
and
sleep has long been known, but it is still not well understood.
Cluster
headache is a brief but severe one-sided head pain with
associated symptoms such as tearing or redness of the eye,
facial swelling,
nasal congestion or runny nose on the side with the pain.
The headaches often occur in REM (rapid eye movement) sleep.
Sleep
apnea is also worse in REM sleep. There is now some evidence
to show that treatment of sleep apnea can reduce the cluster
headaches that occur during sleep.
