Sleep apnea headache: a growing concern in an increasingly obese population?

Abstract

Sleep apnea headache is a recurrent universal pressing headache without accompanying symptoms at awakening that resolves within 4 h. The diagnosis requires polysomnography-verified apnea hypopnea index ≥5, that is, obstructive sleep apnea (OSA). Morning headache has similar symptomatology without OSA. The prevalence of sleep apnea headache is 10–15% in people with OSA, whereas morning headache occurs in 5%. The severity of OSA only slightly affects the prevalence of sleep apnea headache. The pathophysiology of sleep apnea headache remains an enigma, since average oxygen desaturation and lowest oxygen saturation are similar in OSA people without sleep apnea headache. Migraine and tension-type headache are unrelated to OSA. Thus, growing concern of sleep apnea headache in an increasingly obese population is unfounded with our current knowledge.

Keywords::

• migraine and tension-type headache
• morning headache
• obstructive sleep apnea
• sleep apnea headache

Financial & competing interests disclosure

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• • Sleep apnea headache and morning headache have similar symptomatology.

• • Sleep apnea headache and morning headache are mild and short lasting.

• • Sleep apnea headache occurs in people with obstructive sleep apnea (OSA).

• • Morning headache occurs in people without OSA.

• • The prevalence of sleep apnea headache is 10–15%, and it is only slightly affected by severity of OSA.

• • The prevalence of morning headache is 5%.

• • Migraine and tension-type headache are unrelated to OSA.

• • The average oxygen desaturation and lowest oxygen saturation are similar in people with OSA ± sleep apnea headache.

• • Oxygen saturation <90% and average lowest oxygen saturation occur significantly more in those with sleep apnea headache than those with morning headache.

• • The pathophysiology of sleep apnoa headache remains an enigma.

• • Sleep apnea headache/morning usually resolves by itself.

• • Comorbidity of other OSA complaint and/or severe sleep apnea headache might require continuous positive airway pressure.

Notes

Reproduced with permission from [10].