CHRONIC HEADACHES AND SLEEP DISORDERS

Background: Headaches and sleep problems are common complaints in the daily practice of the general practitioner. Since the relationship bet ween headaches and sleep complaints is complex, clear models of intera ction are needed for adequate diagnosis and treatment. Methods: All su bjects, successively seen in a headache clinic during a defined period , were subdivided based on the time of onset of cephalalgia. Subjects who reported onset of headache on a long-term basis, during the noctur nal or early morning (before final awakening) period, were systematica lly studied by a headache clinic and a sleep disorders center. This su bgroup represented 17% of the total headache group. Results: Although the results of the headache clinic study did not differentiate this su bgroup from the other patients, the sleep disorders center's interview s and questionnaires demonstrated a significant impact of the sleep di sorders on headache and daytime function. Nocturnal monitoring during sleep identified specific sleep disorders in 55% of the subjects with onset of headache during the nocturnal sleep period. Follow-up after t reatment of the sleep disorder showed that all subjects with an identi fiable sleep disorder reported either an improvement or absence of the ir headache. The subjects identified with periodic limb movement syndr ome were mostly those who reported only an improvement in their sleep and still needed treatment for their headaches. The question of the in teraction and association of sleep-related headache and periodic limb movement syndrome is unresolved. Conclusion: Headaches occurring durin g the night or early morning are often related to a sleep disturbance.