Sleep apnea in patients with cluster headache: A case-control study.

Keywords: Sleep apnea, obstructive sleep apnea, OSA, continuous positive airway pressure, CPAP, oral appliance, headache, cluster headache, and migraine.

Is there an association between sleep apnea and cluster headache? The University of Münster, Germany Department of Neurology aimed to characterize this association. 42 patients with episodic or cluster headache were compared to 28 healthy patients and matched to age, sex, and BMI (body mass index). During an active cluster episode, patients showed a higher respiratory distress index compared with healthy patients. They found that cluster headache is associated with sleep apnea only during an active cluster episode. At AZTMJ, Dr. Stan Farrell has extensive training in treating sleep apnea and other sleep disorders. In addition, Dr. Stan Farrell is Board Certified and a member of the American Headache Society and a Diplomate with the American Board of Orofacial Pain, making him one of the best choices for your migraine headache treatment. Dr. Stan Farrell offers one of the leading alternatives for the CPAP, which is an oral appliance that can be used in conjunction with a CPAP or as a stand-alone oral appliance depending on the severity of the individual’s OSA. If you or someone you know might be suffering from obstructive sleep apnea and or headache, please schedule an initial consultation today with Dr. Farrell at 480-945-3629 or visit us at for more information.

Evers S1, Barth B2, Frese A3, Husstedt IW2, Happe S4. Department of Neurology, University of Münster, Germany Akademie für Manuelle Medizin, Münster, Germany. Krankenhaus Lindenbrunn, Klinik Maria Frieden, Telgte, Germany.


OBJECTIVE: Polysomnographic investigations have shown an unspecific association between cluster headache and obstructive sleep apnea syndrome. The aim of this study was to investigate this association in a cluster episode compared with a symptom free interval, and to further characterize this association.

METHODS: We investigated 42 patients with episodic (n = 26) or chronic (n = 16) cluster headache by means of polygraphic screening for sleep apnea and compared the data to 28 healthy control subjects matched according to age, sex, and BMI. The patients with episodic cluster headache were screened twice, once in a cluster episode and once in a symptom free interval.

RESULTS: Patients with active cluster headache showed a significantly higher respiratory distress index (8.6 ± 16.0) compared with healthy control subjects (3.4 ± 2.1; p = 0.002). More patients fulfilled the criteria for an obstructive sleep apnea syndrome (29%) than control subjects (7%; p = 0.018). Patients only, but not the control subjects, had central apneas. These differences were only significant when measured during an active cluster episode but not during a symptom free interval.

CONCLUSION: Cluster headache is associated with a sleep apnea syndrome only in the active cluster episode. The increased rate of central apneas might be a result of involvement of the hypothalamus in the pathophysiology of cluster headache. Out of five anecdotal cases treated with nasal continuous positive airway pressure, only one patient showed benefit with respect to cluster headache attack frequency.

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