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Get Some Sleep: Daily headaches? How are you sleeping?
May 3rd, 2011
01:59 PM ET

Get Some Sleep: Daily headaches? How are you sleeping?

Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs on Tuesdays on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.
I have a patient who is a man in his mid-30s who had a headache almost every day of his life for the 10 years before he came to my clinic.  We found that he had significant sleep apnea and the treatment for it has been nothing short of a miracle for him.

Sleep apnea is the most common sleep disorder to present with a complaint of morning headache.  The International Classification of Headache Disorders now has a separate classification for sleep apnea headache.  By definition, the headache is present upon awakening and resolves on its own in 30 minutes or less, and is not better described by another headache disorder.

It has always been presumed that the headaches were caused by the low oxygen levels or high carbon dioxide levels associated with many cases of sleep apnea.  Some studies support this assumption, and other research does not.  Research is also inconclusive about whether treating sleep apnea resolves the headache.  Again, in my practice, I have seen good success.

Sleep apnea is not the only sleep disorder that is associated with increased frequency of headache.  Insomnia, restless legs syndrome (now called Ekbom isease), periodic limb movements, circadian rhythm disorders have all been associated with increased prevalence of headache as is insufficient sleep due to lifestyle choices.

These sleep disorders may cause or more likely exacerbate different types of headache such as migraine, tension headache, cluster and hypnic headache.

Cluster headaches occur in series for several weeks or months (cluster periods) and they have a circadian rhythm with most attacks awakening the patient from sleep.  The location of the pain is around or behind one eye and there is usually swelling, excessive tearing or redness.  There may also be nasal congestion and agitation.

Hypnic headache is a newly described headache syndrome that has been reported only in people older than 50.  It is marked by a dull headache that can vary in location but awakens the patient from sleep usually in the mid to latter portion of the night.  Hypnic headache is not associated with a specific sleep disorder and the prevalence of this type of headache is hard to estimate.

I wish every headache were as easy to cure as it was for my young man with chronic daily headaches.  In fact, in my experience, most of my patients who present with headache as one of the chief symptoms of their sleep disorder usually report a significant decrease in frequency and intensity once we have treated the sleep disorder.

Unfortunately, the research on headache and sleep disorders has often yielded conflicting results with some research  even  failing to show an increase in headache among suffers of sleep disorders much less success with treatment.

One thing is sure, if you suffer from chronic headaches, it is important to rule out any underlying sleep disorders and to optimize the quality and quantity of your sleep.  Sleep problems may not cause the headache, but poor sleep is a powerful trigger.

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Filed under: Sleep

soundoff (31 Responses)
  1. Sleepez

    Dr Oz recommends Lavender for insomnia and restless leg. I like http://www.sleepscentsations.com to help me relax easier and fall asleep better.

    May 3, 2011 at 18:46 | Report abuse | Reply
    • nina786

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      May 4, 2011 at 09:11 | Report abuse |
  2. Cipher3113

    I was just diagnosed with Cluster Headaches after a trip to the ER Sunday morning from recurring, severe headaches that have been waking me up for the past two weeks. The first thing I thought about was the possibility of sleep apnea causing these headaches (I've suspected for a while now that I have sleep apnea, but have not had tests to confirm it. I think snoring like a freight train is proof alone!)

    In the coming months and years I hope there is a lot more light shed on linking major headaches with sleep apnea.

    Excellent article.

    May 3, 2011 at 20:15 | Report abuse | Reply
  3. WellnessDrive

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      May 18, 2011 at 09:06 | Report abuse |
  4. SoundGuy

    Here's a great tip to help you reach a deep sleep, fast: listen to the sounds of nature using comfortable headphones and pay attention to every detail very, very carefully. Sounds of nature are flowing, but at the same time very random, so that you can't anticipate anything. This helps you to keep focused on the sounds, rather than wonder off with some other thoughts (conscious or unconscious), which might me preventing you from relaxing and thus falling asleep. Sites such as TranscendentalTones offer such sounds, which you can easily download to your mp3 player.

    May 4, 2011 at 14:12 | Report abuse | Reply
  5. RaZZZ

    I've suffered from poor sleep my entire life. My mother always mentions how as a baby I would never nap, while my sisters loved to. Now in my adult life I struggle with keeping a healthy, daily routine to ensure I get adequate sleep. Along my journey to find peaceful slumber, I have learned many useful tricks, as well as weeded out the useless ones. There's a great FREE ebook you can download called Get To Sleep Now! at http://instantlyfallasleep.com that lists many helpful techniques as well as things to avoid.
    Many people live fast and stimulating lives, but few of us take the time to unwind before bed. Stimulating activities you want to AVOID before bed are TV, reading, working, computer, stress/fights, and certain foods. The book will always suggest what is beneficial to do before bed, like writing, or talking.

    May 6, 2011 at 07:50 | Report abuse | Reply
  6. Donna McLellan

    I have suffered from daily chronic headaches. I have been dx'd with Sleep apnea, Restless Legs Syndrome,. PLMD, and plain ol' fashioned insomnia. I use lots of relaxation techniques, but if the RLS is in full swing, then that goes out the window if I cannot sit or lay still. I moderate several online groups for sleep disorders, especially RLS, but we have a lot of people with sleep apnea also. There are a lot of things that can help. In my groups, we do not put much stock in the "soap in the bed" thing. I know lavender is very relaxing, but very few people actually get any help from bars of soap, which was what Dr. Oz was talking about. SOME people swear by it, so if it works for you, great! Most of my membersa have very severe RLS., so it takes a bit more than that to try and control it. There are meds that can help, and if you have RLS severely, it is a choice one has to make sometimes. It is that, or go crazy from sleep deprivation. And, just because something is "all natural" does not make it any safer to take without your doctor's permission and knowledge. I hope, too that some day that sleep apnea and headaches are linked, because it seems to me, the people who actually douse a CPAP every night do have less headaches. My biggest group has over 2400 people, so it is a widespread membership from all over, and really does represent a good look at a slice of the world of sleep deprived people. Good article!

    May 10, 2011 at 18:38 | Report abuse | Reply
    • RoguePisigit

      Donna, there is definitely a clear, well-established link between morning headaches and sleep apnea. And as a sleep tech, I can't count the number of patients I've had over the years who are blown away by how treating their apnea can treat their headaches. My husband had horrible morning headaches for years and actually developed a stomach ulcer from all of the NSAIDs he was taking every morning on an empty stomach. After finally beating him into submission and getting him tested and treated, he's definitely become a CPAP believer. It warms my heart to see so many people talking about how CPAP has changed their lives. Makes me feel like my job is worth it! =)

      August 8, 2011 at 03:11 | Report abuse |
  7. Mike

    I suffered from headaches almost daily for 30 years. Saw many specialists. Had surgery on my sinus. Nothing helped I woke with headache and have It all day. Medication simply dulled the pain. Nothing and no doctor helped. I carried out my own researched a decided that I may have sleep apnea. I underwent a sleep test and was diagnosed with sleep apnea. I started using a cpap machine. That was two years ago and since I have been almost headache free. What an amazing change to my life!

    July 31, 2011 at 08:37 | Report abuse | Reply
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