Sleep, sleep apneas, and headache in general population
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Sleep, sleep apneas, and headache in general population Stefania Peruzzo 1 & Carlo Lovati 1 & Marica Pecis 2 & Pierachille Santus 2,3 & Leonardo Pantoni 1,3
# Fondazione Società Italiana di Neurologia 2020
The frequency of head pain episodes is one of the most relevant aspects that influence the impact of headache disorder on the quality of life. It may be modified by many endogenous and exogenous factors, including a series of co-pathologies and multiple lifestyle aspects, especially sleep and related disorders; among which, obstructive sleep apnea syndrome (OSAS) seems particularly able to influence or to induce headache. OSAS is one of the most common disorders of breathing during sleep, characterized by recurrent apneas and hypopneas and snoring, which is able to modify a preexisting primary headache but also to induce a specific secondary headache, labeled as OSAS headache, in subjects who were free from any kind of headache before OSAS’ onset. Notwithstanding the existence of specific diagnostic criteria, the presence of headache in a patient with OSAS is often directly considered a secondary headache caused by OSAS, even if clinical characteristics of headache do not fit the criteria. Moreover, the history of headache is an element that, nowadays, is not enough taken in account when it comes to international diagnostic criteria. Consequently, it seems to be relevant to individuate elements that may help to distinguish between OSAS headache and a preexisting headache modified by OSAS and, in parallel, to determine, in general population, the proportion of these two conditions. In order to find out elements that may help in this difficult challenge, we designed a study to investigate, in general population, the following features: onset latency and fragmentation of sleep, snoring, headache presence, and characteristics. We also aimed to evaluate the reciprocal relationship between sleep
* Carlo Lovati [email protected] 1
Headache Center, Neurology Unit, Luigi Sacco University Hospital, Milan, Italy
2
Division of Respiratory Diseases, Luigi Sacco University Hospital, Milan, Italy
3
“Luigi Sacco” Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
behavior/disorders and headache characteristics in terms of type, frequency, intensity, and clinical symptoms; at last, we purpose to assess, among OSAS patients with recurrent headache, whether OSAS treatment may have effects on headache, independently by its primitive or secondary nature. Clinical data were collected using a telematic ad hoc questionnaire in Google Form format, distributed to population through social media territorial groups. Questions were focused on these three items: sleep behavior, such as latency, fragmentation, and snoring; presence of OSAS and its treatments; and headache and its features in terms of side and kind of pain, modification with physical activity, association with nausea, vomit, photophobia, phonophobia, osmophobia, allodynia, tearing, and rhinorrhea. All of
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