Prevalence and predictors of headache in patients referred to polysomnography

Abstract

BackgroundThe objectives of this study were; (1) to assess the prevalence and frequency of headache in patients referred to polysomnography (PSG) due to a clinical suspicion of obstructive sleep apnea (OSA) or another sleep disturbance and compare with a reference population, and (2) to assess the association of OSA severity with headache and headache frequency.MethodsA total of 784 participants filled in a headache questionnaire between 2003 and 2009 at the Department of Clinical Neurophysiology, Akershus University Hospital. Of these patients 477 were suspected to have OSA, and 307 had other sleep complaints. We assessed the prevalence of headache and monthly headache frequencies, as well as sleep apnea severity using an apnea-hypopnea index (AHI). The association of headache and monthly headache frequencies with PSG subgroups was assessed using multivariate logistic and ordered logistic regression analysis.ResultsThe frequency of headache was not associated with the severity of OSA. Patients referred to a sleep study for any reason had higher odds ratio (OR) for having experienced headache during the past year than population controls after adjustment for age, gender and education, i.e. patients with normal AHI had OR of 3.56, patients with OSA had OR of 3.51, and patients with other sleep disturbances had OR of 3.33. Similarly, the adjusted OR of being in a higher category of monthly headache frequency compared to controls was higher in those with normal AHI (OR 3.42), OSA (OR 3.29), and other sleep disturbances (OR 3.00).ConclusionsThe odds of headache and headache frequency were higher in subjects referred to a PSG for any sleep disturbance independently of OSA, compared to general population controls. However, there was no association between experiencing headache during the past year or headache frequency with OSA severity.

Comprehensive management of adults with chronic migraine: Clinical practice guidelines in Mexico

“…Sleep apnea headache should be excluded when evaluating a preexisting primary headache. 44,45 Adequate treatment of OSAS with chronic headache with CPAP and prophylactic drug therapy proved effective in headaches in 30% of patients with CM. Other authors such as Goksan et al 46 and Loh et al 47 demonstrated that 80–90% of morning headaches improved after appropriate treatment for OSAS.…”

“…Patients with OSAS-associated headaches appear to be more likely to respond to treatment with continuous positive airway pressure (CPAP), confirming its efficacy in headaches, which could differentiate other headaches that mimic sleep apnea headaches. [43][44][45][46] The frequency of morning headaches in participants with OSAS (11.8%) compared to those without OSAS (4.16%) in the general population. 40 Patients with CM and OSAS share common risk factors such as obesity, middle age, and snoring.…”

Sleep Patterns Changes Depending on Headache Subtype and Covariates of Primary Headache Disorders

“…Patients with headache may have poor sleep quality, reduced total sleep time, more awakenings, and alterations in architecture of sleep recorded by polysomnography (PSG) [13]. Prevalance of chronic headache was found to be higher in patients who underwent polysomnographic investigation due to sleep problems [14].…”