Sleep Apnea and Migraine: Is There a Connection?
Getting help to improve migraine is a journey. We may need to consult with more than one doctor. Sometimes other health problems can interfere with effective migraine treatment. Getting a diagnosis and starting treatment for these problems can improve our migraine management. Obstructive sleep apnea is one health problem that can impact migraine.
Before we get into the details of diagnosis and treatment, there are a few terms that need defining.
- Apnea is the absence of airflow when inhaling through the mouth and throat for at least 10 seconds.
- Hypoapnea is the reduction of airflow when inhaling through the mouth and throat for at least 10 seconds.
- Polysomnograpy is a sleep study that tests for obstructive sleep apnea and other sleep disorders. It involves an overnight stay in a sleep lab. Movement, oxygen saturation, respiration and neurological measurements are recorded while you sleep to identify any sleep-related dysfunction.
- CPAP stands for continuous positive airway pressure and is the most common treatment for obstructive sleep apnea. It involves wearing a mask during sleep that produces airflow at sufficient pressure to keep the airway open to prevent the apneas and hypoapneas that disrupt restful sleep.
Obstructive sleep apnea
These apneas cut off oxygen to the brain. In turn, the brain responds by waking us up just enough to breathe deeply. This results in poor sleep quality and daytime sleepiness. Snoring is the most common symptom, but not all snoring is caused by OSA. Another common symptom of OSA is waking up with a headache.
The most common cause of OSA is obesity. Weight loss can reverse OSA in up to 60 percent of patients. Another 30 to 40 percent of patients with OSA have structural abnormalities of the jaw or throat that contribute to the development of OSA. A small and/or recessed jaw, enlarged tongue, tonsils, or uvula can also cause OSA.
Untreated OSA is a risk factor for:
- Cardiovascular disease
- High blood pressure
- Auto accidents
Impact on migraine
Sleep disruptions of any kind can be a potent migraine trigger. If we experience snoring and/or wake up with headache pain, it’s probably a good idea to ask about a sleep study. Eliminating this trigger can dramatically improve our energy levels and migraine attack frequency. Imagine waking up refreshed and pain-free. If untreated OSA is triggering migraine attacks, using a CPAP may be the next treatment option to consider. Talk to your doctor about scheduling a sleep study to identify what sleep problems might be affecting your migraine management.
1 Javaheri S, Barbe F, Campos-Rodriguez F, et al. (2017). Sleep Apnea. Journal of the American College of Cardiology, 69(7), A1-A42.
2 Yang C, Wang S. (2017). Sleep in Patients with Chronic Migraine. Current Pain and Headache Reports, 21(9), 1-7.
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