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Monday, July 5, 2010

ARE CHRONIC HEADACHES AND SLEEP DISORDERS INTER-RELATED?

A new article "Increased Prevalence of Sleep Disorders in Chronic Headache: A Case-Control Study" in the June 2010 issue of Headache addresses this issue. The article (pubmed abstract below) concludes that "Patients with chronic headache had a high prevalence of sleep complaints. Insomnia may thus represent an independent risk factor for headache chronification. Recognition of sleep disorders, alone or in association with depression or anxiety, may be useful in episodic headache patients to prevent chronification."

This recognition of the relation of sleep disorders and chronic headache and migraine is similar to information reported by the NHLBI, National Heart Lung and Blood Institue. The article "Cardiovascular and sleep related consequences of temporomandibular disorders" details the relation of TMJ disorders and sleep apnea. Patients with sleep disorders are prone to chronic headache and headache and TMJ patients are prone to sleep disorders. Are these merely different symptom patterns of the same disorder.

Patients with sleep apnea have a small airwy when awahe that is protected by the neuromuscular system. As sleep moves o deeper phases this neuromuscular compensation fails. Sleep apnea and/or snoring then results. Clenching and Brusism occur when arousal occurs from apnea. Is bruxism and clenching a isease or pathology or is it how the body protects us from airway collapse during sleep?

It appears that sleep apnea is a TMJ disorder that is related to functional development of the oral structures and the airway.

Breastfeeding of infants and early orthodontic expansion may be the best hope of raising a generation of children with healthy cpmpetent airways. This may also be he est method of preventing developmental ADD, ADHD, and other behavioral disordes. A generation of healthier children will increase inteligence and reduce medical expenses on a yearly basis for a lifetime.

Can early treatment of sleep disorders prevent or eliminate lifetime of headaches, migraines. TMJ disorders and other medical disorders. An article in Cranio by Shimshak et al showed a 300% increase in medical expenses in every field of medicinein patients diagnosed with TMJ disorders.

Additional information on sleep apnea can be found at www.ihatecpap.com.

Headache. 2010 Jun 21. [Epub ahead of print]
Increased Prevalence of Sleep Disorders in Chronic Headache: A Case-Control Study.
Sancisi E, Cevoli S, Vignatelli L, Nicodemo M, Pierangeli G, Zanigni S, Grimaldi D, Cortelli P, Montagna P.

From the Department of Neurological Sciences, University of Bologna, Bologna, Italy.
Abstract
Objectives.- The aim of our study was to investigate the prevalence of sleep disorders in chronic headache patients and to evaluate the role of psychiatric comorbidity in the association between chronic headache and sleep complaints. Background.- The prevalence of sleep disorders in chronic headache has been seldom investigated, although from the earliest description chronic headache has been associated with sleep disturbances. On the contrary, mood disorders are commonly associated with both sleep disturbances and chronic headache - each of which are, in turn, core features of mood disorders. Therefore, it may be important to discriminate between sleep problems that can be attributed to a comorbid psychiatric disorder, and those specifically associated with headache. Only a few studies investigating the association of chronic headache with sleep difficulties have also taken into account to consider the possible role of anxiety and depression. Patients and Methods.- A total of 105 consecutive patients with daily or nearly daily headache and 102 patients with episodic headache, matched by age, sex, and type of headache at onset, underwent a structured direct interview about their sleep habits and psychiatric diseases. Results.- In total, 80 out of 105 patients with chronic headache received a diagnosis of medication overuse headache, 21 patients were classified as chronic migraine and 4 as chronic tension-type headache without drug overuse. Patients.- Patients with chronic headache showed a high prevalence of insomnia, daytime sleepiness, and snoring with respect to controls (67.7% vs 39.2%, 36.2% vs 23.5%, and 48.6% vs 37.2%, respectively). Forty-five patients with chronic headache (42.9%) had psychiatric comorbidity (anxiety and/or depressive disorders), vs 27 episodic headache patients (26.5%). Multivariate analysis disclosed that low educational level, lower mean age at headache onset, and insomnia are independently associated with chronic headache. Conclusions.- Patients with chronic headache had a high prevalence of sleep complaints. Insomnia may thus represent an independent risk factor for headache chronification. Recognition of sleep disorders, alone or in association with depression or anxiety, may be useful in episodic headache patients to prevent chronification.

PMID: 20572880 [PubMed - as supplied by publisher]

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posted by Dr Shapira at 7:55 PM

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