Loh N K, Dinner D S, Foldvary N, Skobieranda F, Yew W W
The Cleveland Clinic Foundation, Ohio 44195, USA.
Arch Intern Med. 1999;159(15):1765-8. doi: 10.1001/archinte.159.15.1765.
There is a controversy regarding the association of obstructive sleep apnea (OSA) and morning headaches. This study investigates whether this relationship exists.
This is a retrospective study of 80 consecutive patients with OSA who underwent sleep polysomnography from December 1996 to March 1997. Patients were interviewed about their headache history. Headaches were classified according to International Headache Society criteria and the severity graded by the Chronic Pain Index. Headache characteristics were compared with those of 22 control patients with periodic limb movement disorder. Headache response to continuous positive airway pressure or uvulopalatopharyngoplasty in the patients with OSA was also assessed.
Forty-eight (60%) patients had headaches in the year prior to study. Twenty-five of the 48 patients had headaches that did not fit any category. Of these 25 patients, 23 (48% of total group) reported awakening headaches. These awakening headaches were significantly more common in the OSA group compared with the periodic limb movement disorder group, 9 (41%) of whom had headaches, none of which occurred on awakening. The proportion of common types of headaches in both groups was similar. The awakening headaches were brief (shorter than 30 minutes), and their occurrence and severity correlated with OSA severity. Of the 29 patients with OSA who were treated with continuous positive airway pressure or uvulopalatopharyngoplasty, awakening headaches improved by a mean of 80% compared with minimal improvement of migraine, tension, and cervicogenic headaches.
Awakening headaches are associated with OSA. These headaches are of brief duration, and their occurrence and severity increase with increasing OSA severity. Treatment of OSA with continuous positive airway pressure or uvulopalatopharyngoplasty can reduce these headaches.
阻塞性睡眠呼吸暂停（OSA）与晨起头痛之间的关联存在争议。本研究旨在探究这种关系是否存在。
这是一项对1996年12月至1997年3月期间连续80例接受睡眠多导睡眠监测的OSA患者进行的回顾性研究。对患者进行了头痛病史的访谈。头痛根据国际头痛协会标准进行分类，并通过慢性疼痛指数对严重程度进行分级。将头痛特征与22例患有周期性肢体运动障碍的对照患者进行比较。还评估了OSA患者对持续气道正压通气或悬雍垂腭咽成形术的头痛反应。
48例（60%）患者在研究前一年有头痛症状。48例患者中有25例的头痛不符合任何类别。在这25例患者中，23例（占总组的48%）报告有晨起头痛。与周期性肢体运动障碍组相比，这些晨起头痛在OSA组中明显更常见，该组中有9例（41%）有头痛症状，但均未在醒来时出现。两组中常见头痛类型的比例相似。晨起头痛持续时间较短（短于30分钟），其发生和严重程度与OSA严重程度相关。在29例接受持续气道正压通气或悬雍垂腭咽成形术治疗的OSA患者中，晨起头痛平均改善了80%，而偏头痛、紧张性头痛和颈源性头痛改善甚微。
晨起头痛与OSA有关。这些头痛持续时间短，其发生和严重程度随OSA严重程度的增加而增加。通过持续气道正压通气或悬雍垂腭咽成形术治疗OSA可减轻这些头痛。
