Della Marca G, Vollono C, Rubino M, Capuano A, Di Trapani G, Mariotti P
Institute of Neurology, Department of Neuroscience, Catholic University, Rome, Italy.
Cephalalgia. 2006 Mar;26(3):290-4. doi: 10.1111/j.1468-2982.2005.01037.x.
Cluster headache (CH) is a primary headache with a close relation to sleep. CH presents a circa-annual rhythmicity; attacks occur preferably during the night, in rapid eye movement (REM) sleep, and they are associated with autonomic and neuroendocrine modifications. The posterior hypothalamus is the key structure for the biological phenomenon of CH. Our aim is to describe a 55-year-old man presenting a typical episodic CH, in whom we performed a prolonged sleep study, consisting of a 9-week actigraphic recording and repeated polysomnography, with evaluation of both sleep macrostructure and microstructure. During the acute bout of the cluster we observed an irregular sleep-wake pattern and abnormalities of REM sleep. After the cluster phase these alterations remitted. We conclude that CH was associated, in this patient, with sleep dysregulation involving the biological clock and the arousal mechanisms, particularly in REM. All these abnormalities are consistent with posterior hypothalamic dysfunction.
丛集性头痛（CH）是一种与睡眠密切相关的原发性头痛。CH呈现出近似年度的节律性；发作最好发生在夜间快速眼动（REM）睡眠期间，且与自主神经和神经内分泌改变有关。下丘脑后部是CH生物学现象的关键结构。我们的目的是描述一名55岁患有典型发作性CH的男性，我们对其进行了长时间的睡眠研究，包括为期9周的活动记录仪记录和重复多导睡眠图检查，同时评估睡眠的宏观结构和微观结构。在丛集发作急性期，我们观察到睡眠-觉醒模式不规则以及REM睡眠异常。丛集期过后，这些改变缓解。我们得出结论，在该患者中，CH与涉及生物钟和觉醒机制（尤其是在REM睡眠中）的睡眠调节障碍有关。所有这些异常均与下丘脑后部功能障碍一致。
