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Headache and Sleep Disorders: Review and Clinical Implications for Headache Management
Author(s) -
Rains Jeanetta C.,
Poceta J. Steven
Publication year - 2006
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/j.1526-4610.2006.00578.x
Subject(s) - insomnia , medicine , migraine , sleep disorder , international classification of headache disorders , obstructive sleep apnea , restless legs syndrome , depression (economics) , psychiatry , comorbidity , sleep apnea , cluster headache , anxiety , neurological disorder , pediatrics , physical therapy , anesthesia , central nervous system disease , economics , macroeconomics
Review of epidemiological and clinical studies suggests that sleep disorders are disproportionately observed in specific headache diagnoses (eg, migraine, tension‐type, cluster) and other nonspecific headache patterns (ie, chronic daily headache, “awakening” or morning headache). Interestingly, the sleep disorders associated with headache are of varied types, including obstructive sleep apnea (OSA), periodic limb movement disorder, circadian rhythm disorder, insomnia, and hypersomnia. Headache, particularly morning headache and chronic headache, may be consequent to, or aggravated by, a sleep disorder, and management of the sleep disorder may improve or resolve the headache. Sleep‐disordered breathing is the best example of this relationship. Insomnia is the sleep disorder most often cited by clinical headache populations. Depression and anxiety are comorbid with both headache and sleep disorders (especially insomnia) and consideration of the full headache‐sleep‐affective symptom constellation may yield opportunities to maximize treatment. This paper reviews the comorbidity of headache and sleep disorders (including coexisting psychiatric symptoms where available). Clinical implications for headache evaluation are presented. Sleep screening strategies conducive to headache practice are described. Consideration of the spectrum of sleep‐disordered breathing is encouraged in the headache population, including awareness of potential upper airway resistance syndrome in headache patients lacking traditional risk factors for OSA. Pharmacologic and behavioral sleep regulation strategies are offered that are also compatible with treatment of primary headache.