Hello, and thanks for visiting Headache and Migraine News! I hope that this information will help you and your loved ones find better health in the days ahead.
Due to some personal and work issues that have come up, I will probably be posting a lot less over the summer. For those who once in a while send me a personal note, everything is fine – just very busy! Thanks for your interest. 🙂
I will bring you more news, tips and information when I can. Meanwhile, remember that there are well over 2000 articles here to check out! You can even go to a random post if you like. And just because I may not be able to answer right away, that’s no reason not to ask your questions and keep the discussion going in the comments, and on Facebook and X.
Have a great summer! And keep reading below for new posts…
As terrible as the pain of cluster headache is, there’s more to the story. Research is showing again that there are symptoms of cluster even when there are no headaches.
It’s not rocket science that the brutal pain of cluster affects every part of life – including sleep. But when cluster is “in remission” – that is, patients aren’t currently dealing with a series of headaches – there still appear to be symptoms affecting sleep.
That’s what a study published last year in The Journal of Headache and Pain is telling us.
The study took 50 patients with cluster and 42 without, and measured sleep. That’s a fairly large study for cluster, which is much rarer than migraine.
A key part of the study involved something called “sleep latency”, which simply refers to the amount of time that it takes to get to sleep. Not surprisingly, cluster patients took longer to fall asleep. But surprisingly for some, that was the case even when they weren’t in a cluster cycle (currently having headaches).
Before they went to sleep, cluster headache patients experienced more stress. And when they woke up, they felt less rested.
Also, although they slept about the same number of hours as the control group, they tended to be in bed longer.
Yes, of course, these symptoms were worse in the middle of a cluster cycle. But they didn’t go away in the rest of life.
Why is this the case? Well, it could be a part of the biological reality of cluster. It could also be related to the comorbid diseases that tend to go along with cluster – in other words, cluster patients often have other conditions that tend to go along with cluster headache, that could affect sleep.
There is also the reality that even when you’re not experiencing headache, you may be waiting for the next one to come. Many cluster headache patients do experience headaches in the night – will it be tonight? That being said, researchers noted that even those who didn’t get nighttime attacks still had sleep issues.
Could these sleep issues make cluster headaches worse? Or vice versa? Either way, it’s important for cluster patients and their doctors to recognize that cluster does affect all of life. It’s wise to treat both the cluster headaches themselves and other conditions and symptoms, such as sleep issues.
Researchers hope to continue their study to see if certain treatments can help address sleep issues. It’s hoped that these treatments may lessen cluster symptoms as well.
“Rebreathing” refers to inhaling what you just breathed out – and it’s generally something you want to avoid. A look at the research out there focuses on ways to make sure that it’s not happening, because increasing the levels of CO2 (carbon dioxide) and decreasing levels of oxygen can cause all kinds of problems.
However, we’ve talked about rebreathing in an entirely different context. There is interest in a migraine treatment that carefully controls a certain amount of rebreathing.
The “Rehaler” is an incarnation of this concept. The device uses no drugs – it simply carefully balances CO2 and oxygen. The idea is to use it as an abortive treatment – as you notice a migraine attack coming on.
The Rehaler website explains it like this:
Rehaler works through accurately balanced partial rebreathing, meaning that part of the expired air is captured and subsequently rebreathed together with a controlled amount of atmospheric air. The net effect is an increase of the inspired CO2 percentage to a stable, adjustable level between 1.5 and 3.0%, while retaining normal arterial oxygen saturation (SaO2), no matter how long the device is used.
CO2 has been shown to lessen migraine symptoms in some people, and there are various reasons why this may be (for more, check out this page about the science of Rehaler). This is not something you can try by just using a paper bag over your face, because the oxygen and CO2 level has to be carefully monitored. But when it is, the device seems to be safe to use when a migraine attack is coming on.
And the advantage would be that it could be used over and over – so far it doesn’t seem to have the same limits of many medications. And, you could use it along with migraine meds if needed.
Naturally, Rehaler would come with an app for your phone, which will monitor and track your treatment, as well as providing instructions.
It’s fascinating to see this research continue. It may lead to a very simple migraine treatment, but it also may give us further insight into how migraine actually works. For more, be sure to visit the official Rehaler site!
When we first discussed occipital nerve stimulation back in 2007, the results were promising, but not consistent. Now that’s not unusual for an early study. But when it comes to conditions like cluster headache, there’s another problem.
Cluster headache is certainly a rarer type of headache disorder. So when you have fewer people experiencing it, you’ll also have fewer trying a specific treatment, and fewer people in clinical trials. So it takes a long time to get results – and those results may be less reliable than they would be with a larger group.
Occipital nerve stimulation involves implanting a small device surgically. The device provides “neurostimulation” for the occipital nerves. As this report points out, “the physician aims to target all the occipital nerve branches simultaneously”. The stimulation seems to interrupt pain signals, providing pain relief.
So why doesn’t it consistently “work as advertised”? The researchers found two variables. The first one is – you! The exact makeup of your body is not the same as someone else’s. You can’t just cut someone open and find the exact same nerves in the exact same place.
Now, of course, your surgeon is aware of this. But there’s only so much that a doctor can do.
One thing they can do it standardize surgical techniques. If all doctors, for example, measured in the same way when they implanted the device, we would at least have a more similar treatment.
But that’s not what’s happening. Doctors may use significantly different methods, and also record different information. That means that we can’t even properly compare clinical trials, because we can’t compare exactly what the doctor did.
These researchers are recommending certain points of standardization so that we can properly compare results. This may mean that doctors try to find the best technique based on the current research, and go with that. But it also may mean different techniques that are measured and reported in a standardized way, so that results can be better compared.
When looking for a surgeon, it would be helpful to know what the success rate of this treatment is for their patients. But it also would be nice to know what standards they are following.
This is not just a concern in cluster headache surgery, but in many types of treatment. Though we wouldn’t want to restrict doctors from the treatment they feel is best for you, we also want to make the most of each treatment, so that everyone can improve.
A recent study and review of previous studies came to an interesting conclusion. Maybe migraine headache pain isn’t causing as many sleep problems as we think. But that doesn’t mean migraine and sleep aren’t related.
The study, published earlier this year in the journal Brain Communications, reported on a study with mice to see just how much migraine pain interfered with sleep. And the surprising result was: not much.
Let’s put it this way. Looking at this research and other studies, migraine does seem to affect sleep in certain ways (for example, migraine may affect REM sleep). But we can be forgiven if our perception is an exaggerated connection – when you’re writhing in pain, you’re desperate to sleep – and sometimes sleep just won’t come.
However, for some patients, they do sleep more with migraine. This may be a physical result of migraine itself, or simply because they’re trying to sleep more, and looking for a dark, quiet room.
I would be interested in your comments below, to hear if you have found that migraine pain actually results in less sleep or more sleep overall.
But that’s not the end of the story. The researchers confirmed again that migraine is associated with sleep disorders, and that sleep problems may trigger migraine attacks. In fact, sleep disorders may play a part in migraine becoming chronic. The connection between sleep and migraine is real, but complex. As a simple example, a poor night of sleep may not mean a migraine attack the next day, but it may increase your risk the day after that.
Sleep schedule, along with diet, may be one of the most powerful indicators of future migraine attacks. Though we all get frustrated when we can’t “sleep away” a migraine attack, we should also pay attention to daily sleep patterns in order to prevent future attacks.
