Pergolizzi Joseph V, Magnusson Peter, LeQuang Jo Ann, Wollmuth Charles, Taylor Robert, Breve Frank
NEMA Research, Inc., Naples, FL, USA.
Cardiology Research Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Pain Ther. 2020 Dec;9(2):359-371. doi: 10.1007/s40122-020-00172-6. Epub 2020 May 7.
Cluster headache is a rare form of headache associated with sleep and even speculated to be a manifestation of a sleep disorder rather than a primary headache. Cluster headache exhibits both circadian and circannual rhythmicity. While attacks often occur during sleep, the implication that cluster headaches might be involved with rapid eye movement (REM) sleep phases has neither been fully established nor refuted. The regulatory mechanisms governing sleep including hypothalamic activity and the autonomic nervous system response may play a role. Hypothalamic activation has been observed in cluster headache patients during positron emission tomography testing, but only during attacks. While sleep apnea is associated with morning headaches in general, the link between sleep-disordered respiration and cluster headache remains elusive. Hypoarousal during sleep and periods of hypoxia are associated with cluster headache, the latter likely involving inflammatory processes rather than apnea. Further study is needed, as cluster headaches represent a serious primary cephalgia that is incompletely understood.
丛集性头痛是一种与睡眠相关的罕见头痛形式，甚至有人推测它是睡眠障碍的一种表现，而非原发性头痛。丛集性头痛呈现昼夜节律和年节律。虽然发作常发生在睡眠期间，但丛集性头痛可能与快速眼动（REM）睡眠阶段有关这一观点尚未得到充分证实或反驳。包括下丘脑活动和自主神经系统反应在内的睡眠调节机制可能起作用。在正电子发射断层扫描测试中，已观察到丛集性头痛患者在下丘脑激活，但仅在发作期间。虽然一般来说睡眠呼吸暂停与晨起头痛有关，但睡眠呼吸紊乱与丛集性头痛之间的联系仍不明确。睡眠期间的唤醒不足和缺氧期与丛集性头痛有关，后者可能涉及炎症过程而非呼吸暂停。由于丛集性头痛是一种尚未被完全理解的严重原发性头痛，因此需要进一步研究。
