Sleep-related headaches: clinical features and treatment approaches

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Headaches occurring during sleep are one of the most common types of night time pain complaints, along with back pain. Sleep-related headaches can be a manifestation of both primary headaches (migraine, cluster headache, chronic paroxysmal hemicrania, hypnic headache) and secondary headaches associated with somatic pathology (anemia, hypoxemia), neurological disorders (brain tumors, arteriovenous malformations), psychiatric (depressive, anxiety) and sleep disorders (obstructive sleep apnea). The relationship between headaches and sleep depends on the patient’s age, frequency and severity of the headaches, provoking factors (excessive sleep, sleep deprivation, overuse of painkillers), the stage of sleep (REM sleep or slow-wave sleep) and possible genetic predisposition (hemiplegic migraine).

The connections between sleep and headaches are complex and interrelated. Sleep can both provoke and relieve headaches. On the other hand, headaches can cause sleep disorders, which are typical for a severe type of cephalgia with the development of chronic daily headache syndrome, medication overuse, and psychiatric comorbidity. General anatomical structures, neurochemical and neurophysiological mechanisms involved in sleep and headache regulation are assumed. According to polysomnography data, objective changes in the structure of night sleep were detected in patients with a sleep-related headache: a reduction in the sleep duration and a decrease in the slow-wave sleep representation. Most nighttime headache attacks are linked with the REM sleep phase.

Management of patients with sleep-related headaches should include the diagnosis and treatment of both headache and sleep disorder, which will significantly improve the results of treatment or even cure headaches in some cases.

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About the authors

Аda R. Аrtemenkо

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
ORCID iD: 0000-0002-6219-3384

Russian Federation, Moscow

Olga A. Shavlovskaya

I.M. Sechenov First Moscow State Medical University (Sechenov University)

ORCID iD: 0000-0003-3726-0730

Russian Federation, Moscow

Vera V. Оsipovа

University Headache Clinic; Z.P. Solovyov Moscow Center of Psychoneurology

ORCID iD: 0000-0002-1570-5009

Russian Federation, Moscow

Gennadiy V. Kovrov

MEDSI Clinical and Diagnostic Center

ORCID iD: 0000-0002-3564-6798

Russian Federation, Moscow

Rovshan L. Gasanov

A. Aliev Azerbaijan State Institute of Physicians Training

ORCID iD: 0000-0002-1642-0267

Azerbaijan, Baku, AZ1012


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