Interesting (yet brief) mention of CH and sleep

[Lieutenant2]

I just stumbled across this blog post on CNN's medical page, and I found it interesting for two reasons. First, it actually gives some credence to CH as a standalone affliction, and not some weird subset of the group "headaches"; second, it touches on the whole sleep/circadian rythms angle as related to headaches.

http://thechart.blogs.cnn.com/2011/05/03/get-some-sleep-daily-headaches-how-are-you-sleeping/?hpt=Sbin

I know the blog post is about an apnia headache, but it reinforces something that has been pestering me for a while. How closely linked are sleep cycles (or disruptions thereof) and CH? What is the cause-effect? Is it a chicken or an egg? I really believe there is some knowledge to be gleaned from the sleep angle, as well as from the core temperature angle. I have always had difficulty sustaining REM sleep. And I have just recently started to take my temperature during hits, and have already found that it's elevated.

Hmmmmmmmm. . .

[CHfather]

Thanks, Lt2.  Here's part of a report about a striking study from 2000.  I just can't figure out all the intriguing questions.  Others might know how it's been followed up.  I have been wanting to get my daughter to a sleep-disorder doc.

http://www.respiratoryreviews.com/sep00/rr_sep00_clusterheadaches.html

DOES SLEEP APNEA CAUSE CLUSTER HEADACHES?

ANN ARBOR, MICH--Patients with cluster headaches frequently have undiagnosed sleep-disordered breathing, a recent study has found.[1]

"The key implication of the study is that physicians should consider the possibility of obstructive sleep apnea in patients with cluster headaches because sleep-disordered breathing appears to be common in these patients," Ronald D. Chervin, MD said in an interview with RESPIRATORY REVIEWS. "Preliminary evidence suggests that treating obstructive sleep apnea can improve symptoms in patients with cluster headaches," he added.

Dr. Chervin and colleagues in the Sleep Disorders Center of the University of Michigan in Ann Arbor conducted an observational study to evaluate patients with active or inactive cluster headaches for occult sleep-disordered breathing. Before the start of the study, none of the 25 subjects had been given a diagnosis of sleep-disordered breathing. The researchers performed polysomnography on all subjects, and they monitored end-tidal carbon dioxide and esophageal pressure in 22 and 20 patients, respectively.

Eighty percent of subjects were found to experience more than five episodes of apnea and hypopnea per hour of sleep, and 44% had 10 or more of these events per hour. Minimum oxygen saturation was less than 90% in 10 subjects. Maximum negative esophageal pressure ranged from -13 to -65 cm H2O, and the maximum end-tidal carbon dioxide level was 50 mm Hg or higher in eight subjects. Patients who reported that their cluster headaches typically occurred in the first half of the nocturnal sleep period had more severe oxygen desaturation than did the subjects whose headaches started later.

[Jl924]

the temp thing might be a chicken and egg situation as well...

your in enormous amounts of pain and for many anxiety particularly at medium level hits as you might be anxious that it could go 9-10 which causes all sorts of things which could in turn cause temp to elevate......

the sleep thing is interesting.

Now if we could do a study where we are being monitored all the time to check our temps before, after and during hits that would be great....

in fact a real study would be great

[Lieutenant2]

Nah, there's no money in it! Now, a study on erectile dysfunction and/or hair loss? THAT'S a goldmine! HAHAHA!

We have this thing we use for rehab at fire scenes, it's basically one of those folding bag chairs, but the arms have been replaced with plastic-lined holes that you put your arms into, and cool (not cold) water flows around your forearms. Because there are so many blood vessels close to the surface of the skin, it cools your core temperature down amazingly fast. I'm considering trying it next time I feel a hit coming on, just to see if lowering my temp a couple degrees could have any affect.

[ThatHurtsMyHead]

I can vouch that temperature definitely affects my hits (not cycles).  When in cycle I can get into a hot tub and get a k7+ hit within 10 minutes.  I've found keeping physically cool definitely helps the hits stay at lower kipp when in-cycle.

Jeff

[fireface]

I just went last week to a sleep center and they captured an attack. It came on within the first hour of sleep....still waiting for the Neurologist to get back to me with results... Will get back to you all with the results. Ever take your blood pressure during an attack ? Mine is Sky high.

[CHfather]

Thanks, ff.  This can be really important information.

[ThatHurtsMyHead]

fireface,

Definitely! keep us posted.  Over the years I've been to the emergency room dozens of times and not once did they get off their A$$ quick enough to CT / MRI scan me during the attacks.  I'd sit in the waiting room writhing in pain for an hour or more before getting called back and the hit would always end by the time the Dr ordered the CT or MRI.

Would be very interested in what data they captured during your hit.

Jeff

[Bonkers]

They tried twice with my son when he was getting hit often enough that they thought they might be able to scan him during an attack. Both times there was just no way he could keep still long enough while he was in the machine. This could be VERY interesting.

Ron

[fireface]

Oh Boy... Hope I didn't get everyone's expectations up too high. They didn't run me through a cat scan or Mri...I was just hooked up to monitor brain waves, o2 levels, breathing, temp, heartbeat.... stuff like that. I expect them to say... yep... we see during this period of sleep it started...but they still won't know why the neurotransmitters send my Trigeminal off the deep end. I'll keep ya posted.... Dave

[fireface]

Just spoke with the neurologist office and they want me to come in for another test..They suspect sleep apnea, but it was well after the attack... I'm sure the first test didn't represent a normal nights sleep. They had me hooked up to all this stuff and I laid there thinking ...They're watching every move I make, every breath I take and wondering if I popped a stiffy... would they know that. I'll give it another shot...but don't have big hopes for anything definitive......Dave

[fireface]

Just got the actual charts of my sleep test. I was only asleep for 20mins. when I woke up with HA. During that time I went from stage 1 to stage 2 back to stage 1 and then woke up. What's really interesting is during that 20 mins. I had a very high level of PLMS (Periodic limb movements of sleep (PLMS) consists of sudden jerking movements of the legs which occur involuntarily during sleep and which the affected individual may remain unaware. It may involve kicking, twitching, or extension of the legs. It tends to increase with age and often accompanies restless legs syndrome (RLS).... and I wasn't aware of it. Of course during the attack my heart-rate jumped from 70 to over 100 and after back down to 70. My o2 level increased slightly during the attack then back to 90%..which is normal. After the attack I fell into stage 3 sleep for a couple of hours then awake and asleep several times after that... I think that was just because I wanted out of there. That PLMS registration is kind of interesting. I had a couple of other PLMS hits during stage 3, but not nearly as active as the one before I woke up with HA. I guess it's time to do research on PLMS and CH...see if there is any correlation.

Dave

[fireface]

Also, I should add... nowhere else during the night did I register PLMS during stage 1 or 2.