Migraines headaches are common neurovascular-based head pain that has both genetic and environmental etiologies. Patients with this disorder may develop OSA, but the prevalence of sleep apnea in these patients is unknown. Paiva (38) showed that among individuals with frequent headache arising during the sleep period, 55% had an identifiable sleep disorder including sleep apnea. The mechanism of this relationship is unclear, but some of these individuals are vulnerable to headaches that are provoked by the sleep apnea.
These patients can be routinely studied and do not require any special monitoring. Some patients on opiates may demonstrate significant effect of the medication on respiration. For these individuals carbon dioxide monitoring may be helpful. However, patients otherwise tolerate the studies well and typically can handle CPAP intervention. Therapy for these patients is the same as therapy of the general population. In the general population, CPAP therapy appears to reduce the frequency of headache (39). Poceta (40) reported an individual who had a dramatic decrease in headaches following therapy for the OSA. To date there are no clinical trials demonstrating this effect, but these patients accept the therapy similarly to the general population.
Of note, some patients with trigeminal neuralgia may have difficulty tolerating the CPAP or oral appliance since this may trigger the pain. These patients may need trials with multiple delivery devices, more aggressive therapy for the trigeminal neuralgia or early consideration for neural ablative surgery.
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Headache Happiness! Stop Your Headache BEFORE IT STARTS. How To Get Rid Of Your Headache BEFORE It Starts! The pain can be AGONIZING Headaches can stop you from doing all the things you love. Seeing friends, playing with the kids... even trying to watch your favorite television shows. And just think of how unwelcome headaches are while you're trying to work.