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chronic headache

Acupuncture for chronic headache in primary care – (04-08-04)

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Acupuncture for chronic headache in primary care

This was a relatively large study of patients with headaches being treated with acupuncture 12 times over the course of 3 months. Results were strong in favor of acupuncture. Just add this to the list of effective, non-drug, safe approaches to headache. Manipulation, soft tissue approaches, fever few are just a few others shown to be effective.

bmj.com Abstracts: Vickers et al. 328 (7442): 744

Read entire article here

Obstructive Sleep Apnea: Can Sleep Disturbance Cause Seizures?

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Recent studies have linked sleep apnea and chronic headaches. Since migraines and seizures have similarities, can obstructive sleep apnea cause seizures?

Sleep is absolutely vital to the health of your brain.  During sleep, while our conscious mind may not be alert, this does not mean that our brain is inactive during this time. Far from it.

But sleep is not important because it allows your brain to relax, but rather because processing and healing occurs during sleep that we do not yet fully understand.  It is clear that lack of sleep is a strong trigger for those suffering from migraines and seizures.  For this reason, getting a good night’s sleep is essential for good brain health.

This task is not always as easy as it sounds for several reasons:

  1. In today’s stressed out world, chronic stress throws off normal cortisol rhythms, leading to higher cortisol levels at night, making sleep nearly impossible.
  2. Sleep apnea, both obstructive and central, make restorative sleep impossible.
  3. Our use of medications to help us sleep disrupts normal sleep patterns, potentially being linked to over half of a MILLION deaths per year.

As mentioned earlier, sleep problems have already been linked to chronic headaches and this particular study follows along these same lines as it relates to seizures.  Researchers looked at an epilepsy center and evaluated those patients with seizures for the presence of obstructive sleep apnea and found:

  1. Patients with epilepsy had a much higher incidence of OSA compared to the general population (15.2% vs. 4.41%)
  2. If patient’s seizures were well controlled, then older men with a higher seizure frequency were even more likely to suffer from obstructive sleep apnea.
  3. In those who did not have good seizure control (medically refractory), those with diabetes and snoring had a higher risk of obstructive sleep apnea.
  4. Treatment of obstructive sleep apnea with a CPAP machine in refractory epilepsy patients improved their seizure control.

Clearly there is a link between sleep problems and seizure control.  I would not be surprised at all if the hormone melatonin plays a pivotal role here.  Numerous studies over the years have linked melatonin with protecting the brain and helping with seizure control.  Sleep disturbances can be caused by a problem with melatonin production (or the timing of melatonin production) and, conversely, sleep problems can lead to altered production of melatonin in the brain.

The bottom line is that sleep is critical for normal brain health.  Whether you suffer from chronic headaches or uncontrolled seizures, sleeping has to be brought under control naturally.

The long term solution to sleep problems is stress management and exercise. Few things will restore a healthy sleep pattern as well as these two. In the short term, natural compounds like valerian root may be effective on an individual basis to calm the brain enough to allow sleep to occur naturally.

Melatonin, the hormone mentioned earlier, may also help to restore normal sleep patterns. Typical starting dosages are .5 mg an hour or so before the desired bedtime.

If you have had sleep disturbances in the past, how did you manage them?

Can Sleep Apnea Cause Headaches? Sleep Lab for Chronic Headaches

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Might the horrendous “gasping for air” sound sleep apnea sufferers make cause headaches? If this description fits your night, maybe it’s time to visit a sleep lab.

The brain is a very sensitive organ.  Bombard it with toxic chemicals from the environment, deprive it of fuel or stress it out and it’s not going to be happy with you.

The same goes for oxygen.  Decrease oxygen supply to the brain cells, even by the smallest amount, and you can trigger a headache. 

“But how?” you ask.

When it comes to keeping our brain cells happy and healthy one of the factors that plays a critical role is the ability to carry oxygen to our brains. If the brain doesn’t have enough oxygen, our mitochondria won’t be able to produce the energy (in the form of ATP) that we need, and the brain is not able to function the way it is supposed to.

So, any drop in the ability to deliver oxygen to the brain can create problems. This is exactly the state that many women experience in the second half of their menstrual cycles as the lining of the endometrium begins to build, removing red blood cells from circulation and reducing the ability of the blood to bring oxygen to the brain.

This can be a very subtle drop in red blood cell level, but given how sensitive the brain is to changes in oxygen levels, that can be enough to trigger a menstrual migraine in women who are already sensitive.

While we’re on the subject of reducing oxygen delivery to the brain, what about sleep apnea?

Ask anyone who’s slept next to someone with sleep apnea and they will tell you that it can be a scary experience.  The person can stop breathing many times per hour, leaving the other person in the bed unable to sleep, constantly ready to dial 911 if the breathing doesn’t resume this time…

This is a monumentally bad situation for our health.  And this is on top of the fact that most cases of central sleep apnea are caused by being prediabetic, which carries its own risk to our health.

Clearly this sleep apnea will both stress the body out as well as deprive the brain of oxygen.  As mentioned, this drop in oxygen is not received nicely by the neurons, as we can see from this particular study.

Researchers looked at a group of chronic head sufferers (chronic migraine without aura, episodic migraine without aura, migraine with aura, tension-type headache, chronic post-traumatic headache, medication overuse headache) and identified how many of these experienced sleep apnea.  Here are the findings:

  1. All patients were receiving standard treatment for their headaches by their neurologist.
  2. 63% of the chronic headache sufferers had obstructive sleep apnea (OSA).
  3. Of the patients with OSA, 63% used CPAP and 82% of these used the CPAP as prescribed.
  4. 49% of this group of patients had a positive response to therapy (meds or CPAP)
  5. Patients with OSA who using the CPAP were more likely to have improvement in headaches
  6. Of the 33 patients who used CPAP, 13 reported improvement in headaches specifically due to CPAP therapy.

Overall, this is some pretty strong stuff and would suggest that every chronic headache sufferer should be evaluated at a sleep lab for sleep apnea.  This is, of course, in addition to lifestyle changes designed to improve brain health.

If you use a CPAP and have suffered with chronic headaches, did using the CPAP help your headaches?