Cluster headache and sleep apnea coexistence

This study of sleep changes in patients with cluster headache (CH) was conducted in view of the nocturnal predominance of this condition, the efficacy of oxygen and the fact that the attacks follow oxygen desaturation. Proposed mechanisms include impairment of carotid body activity secondary to hypothalamic vasomotor regulatory dysfunction. Sixteen patients with episodic CH and 29 healthy volunteers underwent nocturnal polysomnography. Five (31.3%) patients with episodic CH were found to have sleep apnea. Two patients with sleep apnea (SA) experienced 2 attacks during the study period. The attacks followed episodes of oxygen desaturation and were associated with REM sleep. In 2 patients with SA and CH, treatment with CPAP abolished their oxygen desaturations, sleep apneas and headaches. Our study confirmed the high percentage of CH associated with SA. We suggest that oxygen desaturation may be a trigger factor in some patients and play a role in the pathogenesis of CH.

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