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Episodic Cluster Headache: NREM Prevalence of Nocturnal Attacks. Time to Look Beyond Macrostructural Analysis?
Author(s) -
Terzaghi Michele,
Ghiotto Natascia,
Sances Grazia,
Rustioni Valter,
Nappi Giuseppe,
Manni Raffaele
Publication year - 2010
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.1526-4610.2010.01658.x
Subject(s) - non rapid eye movement sleep , polysomnography , psychology , eye movement , sleep (system call) , rapid eye movement sleep , audiology , slow wave sleep , psychiatry , medicine , neuroscience , electroencephalography , computer science , operating system
( Headache 2010;50:1050‐1054) Background.— A high prevalence of nocturnal sleep‐related attacks is reported in patients with cluster headache (CH). Episodic CH is considered closely related to rapid eye movement (REM) sleep. Objective.— The aim of this study was to analyze the relationships between episodic CH attacks and sleep macrostructure. Methods.— Data were obtained by means of 24‐hour continuous ambulatory polysomnography (PSG) capturing CH attacks in 4 out of 7 episodic CH patients (all males; mean age 38.4 ± 9.2 years) studied. Results.— Eight CH attacks were captured during the PSG monitoring; 5 arose from sleep: 4 from non‐rapid eye movement (NREM) sleep (stage 2 NREM), and 1 from REM sleep. One patient experienced CH attacks during both NREM and REM sleep in the same night. Conclusions.— In the light of previous literature findings, the prevalence of NREM‐related episodic CH attacks observed, and the finding of attacks arising during both REM and NREM sleep in the same subject, suggest that the relationship between CH and sleep stages is heterogeneous, and the existence of a specific macrostructural pattern associated with episodic CH attacks appears to be uncertain. A more comprehensive approach taking into account the microstructure of NREM and REM sleep is expected to provide more in depth information about the pathophysiology of CH, whose complexity might overcome the simplistic dichotomy of REM/NREM staging.