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Sleep Apnea and Migraine – Comments from You!

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The connection between sleep apnea (sleep apnoea) and migraine is a topic that we’ve covered here more than once.  The September issue of HeadWay (the free headache and migraine ezine) also looked into this link in more depth.

I’ve heard from some of you regarding your experiences…

My 65 year old husband has had migraines since he was a child.  He has never really snored much unless he had a cold.  The symptom that caught the doctors attention 3 years ago was jerking muscles at night.  Sometimes jerking muscles can indicate a lack of oxygen.  An at home oximetry test showed his oxygen level was dropping to 65 at night.  Following a sleep study, CPAP treatment, and oxygen at night his migraine are manageable with Botox and occasional meds now.

To learn more about the oximetry test (pulse oximetry), read What is pulse oximetry? from John Hopkins Medicine.

Sleep Apnea - your comments!

My 40 year old daughter was suffering from debilitating migraines when I subscribed [to HeadWay].  After 2 years and 12 doctors, she was diagnosed with severe sleep apnea and uses a CPap machine and has not had a migraine since then – 7 months. Thanks.

No, it’s not that simple for everyone.  But once again – worth checking out!

I had my first migraine aura w/out pain when I was 30.  Between 30 and 55 I may have had 5 or 6 more episodes.  In my 50’s I gained a great deal of weight and also started having the aura’s 6 to 7 times a year.  I went to a neurologist who did all the testing and again diagnosed migraine aura w/out headache.  Finally I discovered I have sleep apnea.  Since using the CPAP machine I have not had even one aura attack.  My blood pressure has also dropped to 118/78.  I think that I have had sleep apnea all my life (even before I gained the weight).  My aura’s occurred less often before I gained the weight, but my apnea was probably not as severe.  I just hope that everyone knows that sleep apnea can cause these aura’s and the neurologist nor the Optholmologist will necessarily know this.  As a side note one time I even went blind in 1/2 of one eye.  No one should have to be so terrified when the remedy was so simple.

Of course the remedy isn’t simple for everyone.  However, the evidence does suggest that sleep issues are a major factor for many people when it comes to migraine symptoms.

I have had migraines since my teens.  I am 39.  I have had about 2-7 migraines a month since I can remember.  I took every type of medications for them with no relief.  I was diagnosed with severe sleep apnea last November.  Since having my CPAP machine which I use every night I have had only 3 migraines in total this year.  Those three I must say were due to stress and perhaps knocking off the head gear of the CPAP machine.  I never thought I would get relieve from my migraines.  Also I am not a zombie anymore…I actually have energy and can last a day without falling asleep in mid sentence!.  It took some getting use to but if I would have known years ago….I would have saved so many wasted days throwing up and in the worst pain of my life with those migraines!  I haven’t lost any weight using the CPAP nor has my blood pressure dropped….but no migraines….that’s worth millions in my book! (Stacy)

Thanks for all your comments!  It’s great to hear some success stories.  Let’s keep the conversation going! 🙂

More interesting Sleep Apnea Studies

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We’ve been talking a lot here about sleep apnea (sleep apnoea).  There does seem to be a close relationship between sleep apnea and migraine or chronic headache.  In February we talked about a fascinating new study about sleep apnea.

Also, don’t miss the podcast on sleep apnea here.

But Marijke Durning has been posting on some interesting studies on sleep apnea as well, over at Blisstree.  So I just wanted to direct your attention over there – check out Sleep apnea? A simple exercise may help and also Oboe Players May Lower Sleep Apnea Risk.

Anyone feel like taking up a new instrument?  😉

Thanks Marijke!

A Sleep Apnea Mystery Solved?

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Dr. Bradley was puzzled.  These patients with heart and kidney failure often had something else in common.  Sleep apnea.  Why?

In the most recent edition of HeadWay, we were exploring the connection between sleep apnea (or sleep apnoea) and migraine, headaches and cluster headache.  There’s good evidence for a strong relationship.  It seems many people with headache and migraine also have sleep apnea, and we know that sleep patterns are closely related to an increase in these other attacks.

Sleep apnea - new treatment options?

Sleep apnea interrupts sleep, and can make you drowsy during the day.  It can also lead to serious heart problems and diabetes.

But the underlying cause of sleep apnea is not easy to explain.  We know that, for example, obesity is a risk factor.  But many people with sleep apnea are not obese, and are otherwise fairly healthy.  So what’s the problem?

Dr. Douglas Bradley, who we mentioned earlier, noticed that his patients did have something else in common.  Fluid retention (oedema).

Could fluid retention be causing the sleep apnea?

Dr. Bradley and his team set out to study 23 non-obese men.  When these men got horizontal to sleep, the fluid shifted in their bodies, and the circumference of their necks actually increased.  For the control group, it was an increase of 1/2 a centimetre.  But for those with sleep apnea, it was double that, 1 centimetre.  Why?  You guessed it.  Fluid.

So what’s happening?  Dr Bradley explains:

Gravity forces fluid down to the bottom of the body when you are sitting and your legs are inactive.  Standing and walking cause the calf muscles to contract, pumping fluid from the legs up through the veins toward the heart.

When you lie down to sleep, that "extra" fluid gets redistributed, causing the increase in neck circumference, which may be causing blockage leading to some sleep apnea.  (Read the story at Groundbreaking study results could help reduce the incidence of obstructive sleep apnea)

This surprising turn of events leads to some interesting treatments for sleep apnea, and so for the headaches it causes.

The first, best, and most obvious?  Move around!

If you tend to sit or even stand a lot of the day, try changing position, going for walks, getting your leg muscles working.  This keeps the fluid moving through your body the way it’s supposed to.

Dr. Bradley also suggests that elevating your upper body while you sleep may help, interestingly enough something that was recently discussed in a blog carnival entry Sleeping off my headache….

Other common treatments for fluid retention?  Don’t eat too much salt.  Drink plenty of water.  And how about this – one treatment for decreasing fluid retention that comes with the menstrual cycle is magnesium.  We keep coming back to that, don’t we?

One more interesting note.  Some drugs can increase fluid retention, such as NSAIDs (ie naproxen, oxaprozin and ibuprofen), and calcium channel and beta blockers, all commonly used for migraine, and often various types of headache.

Often sleep apnea is treated with special masks worn at night, implants, and even surgery.  But for many, this discovery may lead to solutions that are much less drastic.  And that means a lot less headaches.

Sleep apnea and migraine?

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Sleep apnoea
How are headaches related to sleep apnoea (apnea)?  Recently someone asked me about the relationship between sleep apnea and migraine, something that I had never looked into in depth.

Of course, it’s well known that there’s a solid relationship between cluster and sleep apnoea.  Some studies show that 80% of cluster patients may also suffer sleep apnoea.  Those with this disorder actually stop breathing repeatedly in their sleep.  The fact that it’s far more common in men than women may relate to the correlation with cluster, which is also more common in men.  (Read more about sleep apnea at the Mayo Clinic)

When it comes to migraine, we do know that sleeping problems in general can trigger attacks.  Diane Stafford and Dr Jennifer Shoquist write in Migraines for Dummies:  Too much sleep, or too little, may lead to a migraine.  Any type of off-kilter sleep (insomnia, sleep apnea, and so on) can spin off into a migraine.

A number of things may cause a relation here.  It could be the oxygen/carbon dioxide balance, as is suspected when it comes to cluster.  It could simply be interrupted sleep.  James Weintraub, neurologist and sleep disorder specialist writes:  Migraine headaches occur in direct relationship to the number of REM sleep periods that one has during the night. This relationship is even more pronounced with cluster headaches.

Migraine headaches usually occur either during or after REM sleep or in delta sleep which is the deep sleep that we all require in order to feel alert and refreshed the following day. It remains unclear whether the changes in the neurotransmitter or chemical systems in the brain, hormonal influences, or a combination of several different phenomenon are the cause.

It has also been suggested that sleep problems and migraine are both symptoms of an underlying cause, such as low magnesium levels.  However, this would probably be the exception to the rule.  Migraine attacks are very often directly related to interrupted sleep.  And that’s one thing I know from experience.

Regarding cluster and sleep apnoea, check out this article recently posted at A ClusterHead’s Life.

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