SLEEP APNEA HEADACHE
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One of the more common side effects of sleep apnea is awakening with a sleep apnea headache. Have you been experiencing headaches upon waking up in the morning? Do they last for just a few hours? Do you wake up with headache pain that seems to focus bi-frontally above the eyebrows and that tends to fade after one or two hours? Do you snore or has anyone ever suggested that you might have sleep apnea? If you answered yes to any of these questions, then your morning headaches may be caused by sleep apnea.
One of the most common symptoms of obstructive sleep apnea (OSA) is the occurrence of morning headache. A recent study found that between 18% and 74% of people with moderate to severe sleep apnea awake with a sleep apnea headache. This is compared to only 8.9% of people without sleep apnea. The study also found that women with sleep apnea were more likely than men to suffer from sleep apnea headaches.
Another study published in the journal Neurology looked at the prevalence of snoring in a group of patients that suffered from chronic daily headache (CDH) compared to those who suffered from episodic headaches. Chronic Daily Headache is defined as headache occurring daily or almost daily for at least 15 days per month. The study found that CDH headaches were more associated with sleep disordered breathing. CDH sufferers were more likely to be regular snorers and 24% of those with CDH were found to snore. Of course, the prevalence of snoring is closely correlated with sleep apnea. It has also been shown that sleep disordered breathing is associated with increased incidences of cluster headaches and migraines.
What Causes Sleep Apnea Headache
The classic symptoms of sleep apnea are well known. People with sleep apnea suffer momentary stoppages in breathing while asleep. These temporary stoppages can occur as often as 5 to 50 times every hour during sleep. Obstructive sleep apnea or OSA occurs when a person’s airway becomes partially or completely closed or obstructed. For people with obstructive sleep apnea, tissue in their nasal passages and/or throat can relax and collapse during sleep thereby blocking the airway. If the restriction is significant enough, the person will become starved for air and awaken for a brief period. Every time a person’s airways becomes blocked, their brain and vital organs become oxygen starved. Their autonomic system will respond and cause them to awaken if only for a brief moment. They may awake gasping for breath or even choking. Even though they can wake up as often as 50 times per hour, a sleep apnea patient frequently is not even aware that he/she has been constantly waking up during the night since they usually fall right back to sleep. Over the course of any given night, this pattern of interrupted sleep leaves the sufferer feeling exhausted, irritable, short tempered and often depressed.
As a result of these airway blockages and apnea events, the oxygen level of the blood decreases while the level of carbon dioxide increases. This alters a person’s blood chemistry and increases the risk of high blood pressure, heart attack, stroke, obesity and sleep apnea headache. This blood imbalance is believed to be the primary cause of sleep apnea headaches. Additional factors that are possible causes of sleep apnea headaches include vasodilation and increased intracranial pressure. Morning headaches are just one of many side effects of sleep apnea. Other side effects of sleep apnea include daytime sleepiness, nocturia, increased risk of diabetes and a compromised immune system.
How to Treat Sleep Apnea Headache
You don’t have to suffer with sleep apnea headaches. While the exact cause(s) of sleep apnea headaches is not proven,one thing is certain. When you treat the underlying causes of sleep apnea and reduce its occurence, the prevalence of morning headaches is reduced. Fortunately, sleep apnea headaches can be treated effectively by addressing the underlying problem, namely sleep apnea. Since the headaches are caused by sleep apnea; treat the sleep disorder and the sleep apnea headaches are usually resolved.
Fortunately, most headaches caused by sleep apnea tend to fade by themselves one or two hours after waking because once you are awake and start breathing normally again, the oxygen and carbon dioxide levels in your blood return to normal. Moreover, studies verify that treating a person’s sleep apnea has proven to effectively reduce the incidence of sleep apnea headaches. One study showed that treating sleep apnea with continuous positive airway pressure (CPAP) was found to relieve headache symptoms in 90% of the cases.
While CPAP is the gold standard for treating obstructive sleep apnea, not everyone tolerates it well. As many of 50% of those that try CPAP, do not continue on CPAP therapy long term. Although CPAP treatment has been improved over years by enhancements such as humidification and the development of bi-level therapy, nevertheless the idea of wearing a face mask and being connected to a CPAP machine through a breathing tube all night causes many people to pause. The noise of the CPAP machine, possible stomach bloating and a feeling of claustrophobia can make the prospect of long term CPAP treatment undesirable. So, what can you do if you suffer from morning headaches but you can’t tolerate CPAP treatment?
Alternative Treatments For Sleep Apnea Headaches
- Weight Loss: Since one of the most common causes of obstructive sleep apnea is obesity, losing weight can reduce the excess throat tissue that comes with weight gain and can help prevent the airway collapse and blockage found in OSA.
- Oral Sleep Apnea Devices: For OSA patients that can’t tolerate CPAP, oral devices can often provide an effective alternative. Mandibular Advancement Splints (MAS) work by repositioning the jaw forward, thereby working to prevent the collapse of the airway. There is a wide variety of mandibular advancement splints available that all function to move the jaw forward. Not everyone can use a MAS. Certain dental conditions preclude their use. If this pertains to you, other types of oral devices such as Tongue Retainers may help. They work by pulling the tongue forward and preventing it from falling back into the throat and blocking the airway. Oral sleep apnea devices are usually fitted by a dentist trained in treating sleep apnea.
- Surgery: For patients with severe sleep apnea or for those that just can’t tolerate other sleep apnea treatments, many sleep apnea surgery options have been developed. Their level of success, invasiveness and recovery times vary greatly. Some procedures such as Pillar Palatal Implants can be performed in a doctor’s office with minimal pain or discomfort. Other procedures that reconstruct the jaw are serious operations with prolonged recovery times. Obviously, consult with your doctor and consider seeking multiple medical opinions before considering surgery to treat your sleep apnea.
- Sleep Apnea Exercises: Since obesity is a major contributing factor to sleep apnea, an overal fitness and exercise program that leads to weight loss can be an effective sleep apnea treatment. In addition, there are several sleep apnea exercises that are designed to tone and strengthen the tissue and muscles of the throat, tongue and soft palate. A study published in the British Medical Journal found that playing the Didgeridoo musical instrument helped people achieve significant reductions in their AHI scores. The circular breathing required to play the Didgeridoo is thought to play a role in improving the muscle tone of the muscles in the throat.
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