Tips

26 January 2018

CPAP and Headache: for Better or for Worse?

James Discoveries & Stats, Information, Tips, Treatments 3

Most people know CPAP (Continuous Positive Airway Pressure) as a treatment for sleep apnea. Essentially, a machine connect to a mask, which pumps air under pressure to the lungs, keeping the windpipe open while you’re asleep. The windpipe remains “unobstructed”, thus helping with obstructive sleep apnea.

CPAP and Headaches — Illustration courtesy PruebasBMA

But over the past few years, patients and researchers have become interested in another aspect of CPAP machines. That is, their relation to headaches.

There are three aspects to this question:

Could CPAP machines actually cause headaches, or at least make them worse?
Is sleep apnea related to headaches and migraine? In other words, could treating sleep apnea also fight headaches?
Could CPAP machines be a treatment for headaches, migraine, and even cluster headache?

Let’s start with #1. Yes, some people have noticed an increase in headache symptoms when they use the CPAP machine. This shouldn’t be surprising – any significant change can certainly trigger an attack in people with migraine disease.

However, there may be some good solutions (besides avoiding CPAP treatment). One would be “giving it time”, of course, but one business focused on sleep related medical equipment reports that there could be a simple solution:

Sinus systems extend behind your ears. When a CPAP is used and part of the sinus cavities are blocked, a situation is created where there is a pressure differential between the sinus cavities affected. These pressure differences can sometimes be felt as sinus headaches or just plain headaches, even though they are caused by sinus blockages. These can be treated using over the counter medications to open the sinus. CPAP heated humidifiers can also open and maintain sinus systems. If you do not use a heated humidifier, we strongly suggest using one. If this does not correct the problem, visit your ENT. [Why do I have a headache when I wake up?]

These are common recommendations from both companies with experience and doctors. Check if a pressure adjustment is needed, and consider a CPAP heated humidified (and make sure it’s working properly).

Also, you may have a reaction to the straps used for the mask. See if you can loosen them or try a different type of mask/strap.

While a temporary increase in headache symptoms may be common, it’s also common that headache symptoms decrease – or disappear – when a patient starts using a CPAP.

A few people from our community have shared their stories of unexpected success – see Sleep Apnea and Migraine – Comments from You!

It seems that sleep apnea (sleep apnoea) is a significant trigger for headache attacks, such as those from migraine. In 2013, for example, a study was released that showed significant improvement in migraine patients with sleep apnea who started using CPAP (CPAP Improves Migraine Burden in Patients With Sleep Apnea). Another study also found that patients with obstructive sleep apnea and migraine often improved significantly if they were committed to CPAP treatment.

Could CPAP work specifically as a treatment, even if patients aren’t diagnosed with sleep apnea? And which patients are most likely to benefit?

Much more study is needed, and some studies are beginning. For example, a CPAP study in Norway will be evaluating the use of CPAP for cluster headache treatment.

In the mean time, it’s very important for doctors to pay attention to the sleep patterns of headache patients. There are probably a high number of patients with headache symptoms who have undiagnosed obstructive sleep apnea. In fact, doctors could make a lot of headway just by asking a simple question – When you woke up this morning, did you feel refreshed?

For more on sleep apnea and migraine in particular, listen to this podcast.

11 December 2017

Lipoic Acid for Migraine

James Discoveries & Stats, Tips, Treatments 0

Some doctors have recommended lipoic acid as a supplement treatment for migraine. So what exactly is it?

Alpha-lipoic acid (also known as thioctic acid or ALA, or there is also RLA, the naturally-occurring version) is a chemical that is found in some plants, and actually is made by your own body. It’s an antioxidant, and so helps keep your body healthy while it fights inflammation. It also helps your body maintain proper levels of vitamin C and vitamin E. Both of these may play a major role in fighting migraine and headache.

Broccoli and Lipoic Acid Now, we’re all for antioxidants and healthy foods, but why ALA in particular? And why haven’t you heard about it from your doctor?

The evidence for ALA for migraine is still fairly sparse, just because there haven’t been many studies on it. A study in 2007 suffered because not enough patients were recruited for the study. However, the study seemed to show fewer headache days, and less intense headaches, with ALA. This was over 3 months (see A randomized double-blind placebo-controlled trial of thioctic acid in migraine prophylaxis..

ALA is much better known as a treatment for diabetics, to decrease nerve pain. In that case, patients take 600mg or more per day in two doses. It’s also taken for weight loss and mental clarity. (Lots more information here: Alpha Lipoic Acid: Improve Insulin Sensitivity & Fight Diabetes!. Also see Alpha-Lipoic Acid.)

600mg was also the amount used in the migraine study.

Because lipoic acid comes from food, your best bet is probably to eat more ALA-rich foods. Broccoli is one of the best all-round foods for a migraine patient. Also try organ meat (liver, heart), spinach, and tomatoes.

So here are some things to consider:

Get ALA from food. This is almost a no-brainer, since we already know that foods like broccoli have so many benefits. Also try adding peas, brussel sprouts, carrots and beets to your diet.
ALA can be taken as a supplement for general health. You could try 50-100mg per day.
If you would like to try ALA specifically for migraine prevention, talk to your doctor about a 600mg dose.

Which supplement? An excellent version of thioctic acid is Country Life R-Lipoic Acid. It contains no gluten or milk or preservatives and is vegetarian. It’s also one of the less-expensive versions of RLA, and was tested and approved by Consumer Lab.

If you’re taking a higher dosage, an even less expensive version (also tested by Consumer Labs) is Vitacost Alpha Lipoic Acid. This would be a good option if you’re going the 600mg route, because you can take it in two doses.

Finally, if you’re looking for one of the highest rated brands on Amazon, Doctor’s Best has a whole series of lipoic acid products to choose from. The reviews themselves are an interesting read, if you want to hear about how this supplement is actually helping people.

9 November 2017

So – Should I Exercise Less?

James Discoveries & Stats, Tips 1

One of the interesting revelations at the 18th Congress of the International Headache Society this September in Vancouver was that we should seriously think about exercising less. Well, for less time. Sort of.

Exercise Partners Most of us already know that the most amazing “pill” to take to keep the migraine monster at bay is exercise. Just a little more movement every week can make a huge difference over time.

But those who want to get some serious exercise in over the course of a week often have a problem. Well, a few problems maybe. But for the purpose of this article, the problem is time. Where in our busy (and often migraine-interrupted) schedules are we ever going to find time?

Yes, we know that the exercise will pay off – fewer migraine days, more energy, being more alert and productive. But sometimes that isn’t enough to motivate us.

But this study out of Switzerland might help a little.

The study of 20 women and 4 men included two different exercise plans:

45 minutes twice per week = 90 minutes per week
28 minutes twice per week = 56 minutes per week

Both groups saw a significant improvement – fewer migraine days. But the second group experienced a MUCH greater improvement.

What’s the catch? Well, the catch – sort of – is that both groups burned the same number of calories. In other words, the second group had more intense exercise.

You can read the actual details of the two types of exercise here: High-Intensity Training Bests Moderate Exercise for Migraine

The group that improved the most used HIT, or high-intensity interval training . But remember, they exercised less per week and had a much better result. In fact, over a year, they would exercise for 26.5 hours less than the other group – that’s more than a day of your life. (Actually, almost two days, depending on how much sleep you get!)

Why the difference? Lead author Alice Minghetti explains:

After you do high-intensity training, your body for a long period has to have certain adaptations in your system, so you need more oxygen after the workout than you do when you have just continuous, moderate-pace exercise. So especially for people who are busy or actually enjoy high intensity…it’s a better exercise regimen.

The drawback for migraine patients is that our brains don’t like change. Sudden changes such as those in high intensity training could trigger attacks in some. But remember, these were migraine patients. And even with that issue, headache days were fewer with either kind of exercise.

So, if you can, give it a try. If you just can’t – increase your exercise – or any kind of movement – little by little. It may be your best treatment.

16 October 2017

Staying Hydrated when Flying

James Tips 0

A recent article at Lifehacker has a good reminder for those prone to migraine attacks – stay hydrated when you fly.

flight over water — Water on the outside, dry on the inside!

We’ve discussed tips for avoiding “airplane headache” here before. But airplane headache is, oddly enough, not the only type of headache you can get from flying. You may also trigger another type of headache from changes in pressure, not moving around enough, or not staying hydrated.

The Lifehacker article notes that airplanes are extremely dry. Plus, added sweating and activity before and after travel, and limited access to fluids – it’s very easy to get dehydrated.

I’ll let you read their tips for yourself. These tips alone could help many people avoid headache on travel days, although it will depend on what type of headache you have.

However, as you’re motivated to stay more hydrated on your next flight, you might also want to plan ahead – and get an isle seat. Just sayin’.

How to Keep Properly Hydrated on a Long Flight (Lifehacker)

13 July 2017

Migraine, Headaches, and Support (poll results)

James Tips, Website news 0

Having people around you who are supportive – even one person – can make an incredible difference. Recently we ran a poll to find out about the closest person in your life – just how supportive are they?

First of all, for about 9% of you, the closest person is someone who is not only very supportive, but also has the same condition. But let’s leave those aside for the moment, and look at the rest.

The support of friends Actually, I was happy to hear how many of you have a very supportive person close to you. 13% just raved about the amazing support, another 11% also incredibly supportive, and then 13% very supportive – getting us to 37%, plus those with the same condition, getting us to 46% who are very supportive to varying degrees.

But that is less than half. What’s next? Another 10% have at least taken some time to understand. So that gets us to 56% of friends/family who are at least pro-active.

Next are those who are at least aware that you get headaches/migraine attacks – 35%. Another 5% are only vaguely aware.

Finally, 6% reported that the closest person to them didn’t even know that they had headache/migraine attacks!

So I’m glad to see that many of you have friends and family who are extremely supportive. But really, that’s only half of you. For the other half, the closest person to you has either done very little to try to understand, or – let’s face it – you haven’t shared much!

I realize there are a lot of reasons why this might be. But we need to be pro-active ourselves to make sure that we have people very close to use who know what our struggles are. If it isn’t going to be the person closest to you, look to others who are close to you. Find someone you can talk to, and actually sit down with them this weekend and have the conversation. If you have to, tell them your friend James said it was important for your health. 😀

Let’s get the percentage up to 75% – then to 100% – so that we all have a person close to us who is very supportive. And remember – we need to be supportive of others too!

Here are some inspiring notes from people who do have a supportive friend/family member. And here are some ideas about how faith communities and others can be supportive.