Sleep Disorders and Headache
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Cluster Headache: a Review MARILYN J
• Cluster headache: A review MARILYN J. CONNORS, DO ID Cluster headache is a debilitat consists of episodes of excruciating facial pain that ing neuronal headache with secondary vas is generally unilateraP and often accompanied by cular changes and is often accompanied by ipsilateral parasympathetic phenomena including other characteristic signs and symptoms, such nasal congestion, rhinorrhea, conjunctival injec as unilateral rhinorrhea, lacrimation, and con tion, and lacrimation. Patients may also experi junctival injection. It primarily affects men, ence complete or partial Horner's syndrome (that and in many cases, patients have distinguishing is, unilateral miosis with normal direct light response facial, body, and psychologic features. Sever and mild ipsilateral ptosis, facial flushing, and al factors may precipitate cluster headaches, hyperhidrosis).4-6 These autonomic disturbances including histamine, nitroglycerin, alcohol, sometimes precede or occur early in the headache, transition from rapid eye movement (REM) adding credence to the theory that this constella to non-REM sleep, circadian periodicity, envi tion of symptoms is an integral part of an attack and ronmental alterations, and change in the level not a secondary consequence. Some investigators of physical, emotional, or mental activity. The consider cluster headache to exemplify a tempo pathophysiologic features have not been com rary and local imbalance between sympathetic and pletely elucidated, but the realms of neuro parasympathetic systems via the central nervous biology, intracranial hemodynamics, endocrinol system (CNS).! ogy, and immunology are included. Therapy The nomenclature of this form of headache in is prophylactic or abortive (or both). Treat the literature is extensive and descriptive, includ ment, possibly with combination regimens, ing such terminology as histamine cephalgia, ery should be tailored to the needs of the indi thromelalgia of the head, red migraine, atypical vidual patient. -
Migraine; Cluster Headache; Tension Headache Order Set Requirements: Allergies Risk Assessment / Scoring Tools / Screening: See Clinical Decision Support Section
Provincial Clinical Knowledge Topic Primary Headaches, Adult – Emergency V 1.0 © 2017, Alberta Health Services. This work is licensed under the Creative Commons Attribution-Non-Commercial-No Derivatives 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/. Disclaimer: This material is intended for use by clinicians only and is provided on an "as is", "where is" basis. Although reasonable efforts were made to confirm the accuracy of the information, Alberta Health Services does not make any representation or warranty, express, implied or statutory, as to the accuracy, reliability, completeness, applicability or fitness for a particular purpose of such information. This material is not a substitute for the advice of a qualified health professional. Alberta Health Services expressly disclaims all liability for the use of these materials, and for any claims, actions, demands or suits arising from such use. Revision History Version Date of Revision Description of Revision Revised By 1.0 March 2017 Topic completed and disseminated See Acknowledgements Primary Headaches, Adult – Emergency V 1.0 Page 1 of 16 Important Information Before You Begin The recommendations contained in this knowledge topic have been provincially adjudicated and are based on best practice and available evidence. Clinicians applying these recommendations should, in consultation with the patient, use independent medical judgment in the context of individual clinical circumstances to direct care. This knowledge topic will be reviewed periodically and updated as best practice evidence and practice change. The information in this topic strives to adhere to Institute for Safe Medication Practices (ISMP) safety standards and align with Quality and Safety initiatives and accreditation requirements such as the Required Organizational Practices. -
Autonomic Headache with Autonomic Seizures: a Case Report
J Headache Pain (2006) 7:347–350 DOI 10.1007/s10194-006-0326-y BRIEF REPORT Aynur Özge Autonomic headache with autonomic seizures: Hakan Kaleagasi Fazilet Yalçin Tasmertek a case report Received: 3 April 2006 Abstract The aim of the report is the criteria for the diagnosis of Accepted in revised form: 18 July 2006 to present a case of an autonomic trigeminal autonomic cephalalgias, Published online: 25 October 2006 headache associated with autonom- and was different from epileptic ic seizures. A 19-year-old male headache, which was defined as a who had had complex partial pressing type pain felt over the seizures for 15 years was admitted forehead for several minutes to a with autonomic complaints and left few hours. Although epileptic hemicranial headache, independent headache responds to anti-epilep- from seizures, that he had had for tics and the complaints of the pre- 2 years and were provoked by sent case decreased with anti- watching television. Brain magnet- epileptics, it has been suggested ౧ A. Özge ( ) • H. Kaleagasi ic resonance imaging showed right that the headache could be a non- F. Yalçin Tasmertek hippocampal sclerosis and elec- trigeminal autonomic headache Department of Neurology, troencephalography revealed instead of an epileptic headache. Mersin University Faculty of Medicine, Mersin 33079, Turkey epileptic activity in right hemi- e-mail: [email protected] spheric areas. Treatment with val- Keywords Headache • Non-trigemi- Tel.: +90-324-3374300 (1149) proic acid decreased the com- nal autonomic cephalalgias • Fax: +90-324-3374305 plaints. The headache did not fulfil Autonomic seizure • Valproic acid lateral autonomic phenomena and/or restlessness or agita- Introduction tion [3]. -
Headache: a Patient's Guide (Pdf)
Headache A Patient’s Guide Kathleen Digre, MD • Susan Baggaley, APRN • K.C. Brennan, MD • Seniha Ozudogru, MD 729 Arapeen Drive Salt Lake City, Utah 84108 801.585.7575 headache.uofuhealth.org Headache: A Patient’s Guide eadache is an extremely common problem. It is estimated that 10-20% of all people have migraine. Headache is one of the most common reasons H people visit the doctor’s office. Headache can be the symptom of a serious problem, or it can be recurrent, annoying and disabling, without any underlying structural cause. WHAT CAUSES HEAD PAIN? Pain in the head is carried by certain nerves that supply the head and neck. The trigeminal system impacts the face as well as the cervical (neck) 1 and 2 nerves in the back of the head. Although pain can indicate that something is pushing on the brain or nerves, most of the time nothing is pushing on anything. We think that in migraine there may be a generator of headache in the brain which can be triggered by many things. Some people’s generators are more sensitive to stimuli such as light, noise, odor, and stress than others, causing a person to have more frequent headaches. THERE ARE MANY TYPES OF HEADACHES! Most people have more than one type of headache. The most common type of headache seen in a doctor's office is migraine (the most common type of headache in the general population is tension headache). Some people do not believe that migraine and tension headaches are different headaches, but rather two ends of a headache continuum. -
Chronic Insomnia Disorder in Australia
Chronic Insomnia Disorder in Australia A REPORT TO THE SLEEP HEALTH FOUNDATION 1,2 1. Appleton Institute, CQUniversity Australia 44 Greenhill Amy C Reynolds Road, Wayville SA 5034 3,4 Sarah L Appleton 2. School of Health, Medical and Applied Sciences, CQUniversity Australia 4,5 Tiffany K Gill 3. Adelaide Institute for Sleep Health: A Flinders Centre of Robert J Adams 3,4 Research Excellence, Flinders University, Bedford Park, SA. 4. The Health Observatory, Adelaide Medical School, The University of Adelaide, SA. 5. South Australian Health and Medical Research Institute, Adelaide, Australia Chronic Insomnia Disorder in Australia A Report to the Sleep Health Foundation Amy C Reynolds1,2, Sarah L Appleton3,4, Tiffany K Gill4,5 & Robert J Adams3,4 1. Appleton Institute, CQUniversity Australia 44 Greenhill Road, Wayville SA 5034 2. School of Health, Medical and Applied Sciences, CQUniversity Australia 3. Adelaide Institute for Sleep Health: A Flinders Centre of Research Excellence, Flinders University, Bedford Park, SA. 4. The Health Observatory, Adelaide Medical School, The University of Adelaide, SA. 5. South Australian Health and Medical Research Institute, Adelaide, Australia This work was supported by the Sleep Health Foundation, an Australian not‑for‑profit organisation devoted to improving sleep health, and an unrestricted grant from Merck Sharp & Dohme (Australia) Pty Limited which had no part in conception, planning, execution or write‑up of it. Publication and graphic design by Flux Visual Communication www.designbyflux.com.au July 2019 2 Chronic Insomnia Disorder in Australia EXECUTIVE SUMMARY Sleep problems are common and costly to the Australian community. One common sleep condition is insomnia. -
Primary Headaches and Their Relationship with Sleep Cefaleias Primárias E Sua Relação Com O Sono
Yagihara F, Lucchesi LM‚ Smith AKA, Speciali JG 28 REVIEW ARTICLE Primary headaches and their relationship with sleep Cefaleias primárias e sua relação com o sono Fabiana Yagihara1, Ligia Mendonça Lucchesi1, Anna Karla Alves Smith1, José Geraldo Speciali2 ABSTRACT pain control systems. In general, pain affects sleep and vice There is a clear association between primary headaches and sleep versa(1,2). We found that primary headaches with no clear disorders, especially when these headaches occur at night or upon etiology by clinical and laboratory tests can be triggered by waking. The primary headaches most commonly related to sleep either short or long periods of sleep, or by interrupted or are: migraine, cluster headache, tension type, hypnic headache and (3) chronic paroxysmal hemicrania. The objective of this review was to non-restorative sleep . Sleep is also effective in relieving describe the relationship between these types of headaches and sle- symptoms: 85% of individuals with migraine report that ep and to address sleep apnea headaches. There are various types of they choose to sleep or rest because of a headache, and demonstrated associations between sleep and headache disorders, many are forced to do it(4). Therefore, headaches and sleep and the mechanisms underlying these associations are complex, multi-factorial and poorly understood. Moreover, all sleep disorders disturbances are common and often coexist in the same may be related to headaches to some degree; therefore, the evalua- individual(3,5), and this association is especially observed tion of patients with headaches should include a brief investigation when these headaches occur at night or upon waking(6,7). -
Headaches and Sleep
P1: KWW/KKL P2: KWW/HCN QC: KWW/FLX T1: KWW GRBT050-134 Olesen- 2057G GRBT050-Olesen-v6.cls August 17, 2005 2:18 ••Chapter 134 ◗ Headaches and Sleep Poul Jennum and Teresa Paiva Headache and sleeping problems are both some of the maintaining sleep), hypersomnias (with excessive day- most commonly reported problems in clinical practice and time sleepiness), parasomnias (disorders of arousal, par- cause considerable social and family problems, with im- tial arousal, and sleep stage transition), or circadian portant socioeconomic impacts. There is a clear associa- disturbances. tion between headache and sleep disturbances, especially Sleep is regulated by a complex set of mechanisms headaches occurring during the night or early morning. including the hypothalamus and brainstem and involv- The prevalence of chronic morning headache (CMH) is ing a large number of neurotransmitters including sero- 7.6%; CMH is more common in females and in subjects tonin, adenosine, histamine, hypocretin, γ -aminobutyric between 45 and 64 years of age; the most significant asso- acid (GABA), norepinephrine, and epinephrine (65). How- ciated factors are anxiety, depressive disorders, insomnia, ever, the specific roles in the relation between sleep and and dyssomnia (75). headache disorders are only partly known. However, the cause and effect of this relation are not clear. Patients with headache also report more daytime symptoms such as fatigue, tiredness, or sleepiness and COMMON HEADACHE TYPES sleep-related problems such as insomnia (77,52). Identi- AND THE RELATION TO SLEEP fication of sleep disorders in chronic headache patients is worthwhile because identification and treatment of sleep Commonly reported headache disorders that show rela- disorders among chronic headache patients may be fol- tion to sleep are migraine, tension-type headache, cluster lowed by improvement of the headache. -
Sleep Disorders and Deprivation Causes and Effects on College Students Reham Karana Biology, Bachelors of Science to the Honors
Sleep Disorders and Deprivation Causes and Effects on College Students Reham Karana Biology, Bachelors of Science To The Honors College Oakland University In partial fulfillment of the requirement to graduate from The Honors College Mentor: Jessica Koppen, Professor of Chemistry Department of Chemistry Oakland University (February 15, 2018) Introduction When told to picture a college student, a picture of a student in a library frantically studying for their next exam will most likely come to mind. Others might picture college students in a social environment among their peers, participating in a sorority, or even at a raucous party. What most will not picture a college student doing is simply sleeping. A growing and unattended problem among college students is their common day-time sleepiness and increased sleep disorders. A student’s sleep is no longer driven by the light and dark cycle but rather but their school schedule, academic load, and socialization. To maximize success in college, an obstacle most students have now endured is a lack of sleep and potential sleep disorders. What most do not know is this could actually do the opposite and hurt academic performance (Allan, 2015). Current research has shown that fifty percent of college students report daytime sleepiness and seventy percent experience insufficient sleep (Hershner, 2014). This can adversely affect one’s academic performance due to sleep having vital biological effects on the human body (Gaultney, 2010). According to The American Academy of Sleep Medicine, students that maintain a sufficient amount of sleep per night performed better on memory and motor tasks than students deprived of sleep (“College Students”, 2015). -
Cluster Headacheheadache
ClusterCluster HeadacheHeadache 1 OBJECTIVESOBJECTIVES Describe the clinical features and diagnosis of cluster headache Discuss the pathogenesis of cluster pain and autonomic features Review acute and preventive therapy Overview of new treatment horizons for refractory chronic cluster 2 IHSIHS CLASSIFICATIONCLASSIFICATION Cluster headache n Episodic type (80%) n Chronic type (20%) (Cluster period lasts for more than one year without remission or remission lasts less than 14 days) Episodic Chronic IHS Headache Classification Committee. Cephalalgia. 2004. Although the unique clinical features of cluster headache (CH) have been recognized since the 17th century, the striking periodicity was not articulated until the 1940s. The term “cluster headache” was coined in the 1950s, and since then the International Headache Society (IHS) has identified and classified two major temporal patterns of CH (1). The episodic type (ECH), by far the most common (90%), is characterized by discrete attack and remission phases. The chronic type (CCH) is defined by attacks that occur daily for more than one year without remission or with remission periods lasting less than 14 days. Cluster headache is rare (about 0.4% of the general population), and it predominates in males, although recent studies indicate that the rate in females is rising (2). Onset can occur at any age but usually begins between 30 and 50 years of age (3). In contrast to migraine headache, genetics in cluster headache is not thought to be important, although recent studies have shown a positive family history in about 7% of patients with cluster headache. When compared with prevalence of CH in the general population, first-degree relatives have about a 14-fold increased risk of developing CH. -
Parasomnias Fact Sheet
Fact Sheet Parasomnias Overview Parasomnias are unusual things we do or experience while asleep or while partially asleep. Almost everyone has a nightmare from time to time. When someone has nightmares frequently, and they are very distressed about them, they may have Nightmare Disorder. Nightmare Disorder is considered a parasomnia since it is an unpleasant event that occurs while asleep. The term parasomnia is much broader than nightmares, and a person with Nightmare Disorder has more than just the occasional nightmare event. In addition to Nightmare Disorder, other common parasomnia events include: REM Behavior Disorder (RBD) Sleep paralysis Sleepwalking Confusional arousals What are common parasomnias? Typically parasomnias are classified by whether they occur during the rapid eye movement (REM) sleep or Non- REM sleep. People with an REM parasomnia are more likely to recall their unusual sleep behaviors (for example, nightmare) than those with a Non-REM parasomnia (for example, sleepwalking). REM Behavior Disorder (RBD) Most dreaming occurs in REM sleep. During REM sleep, most of our body muscles are paralyzed to prevent us from acting out our dreams. In REM Behavior Disorder (RBD), a person does not have this protective paralysis during REM sleep. Therefore, they might “act out” their dream. Since dreams may involve violence and protecting oneself, a person acting out their dream may injure themselves or their bed partner. The person will usually recall the dream, but not realize that they were actually moving while asleep. Sleep Paralysis and Sleep Hallucinations During REM sleep our muscles are paralyzed to keep us from acting out our dreams. -
A Cognitive Behavioral Exposure Treatment Package for Night Terrors: a Case Study
Send Orders of Reprints at [email protected] 8 The Open Sleep Journal, 2013, 6, 8-11 Open Access A Cognitive Behavioral Exposure Treatment Package for Night Terrors: A Case Study Steven J. Linton* Center for Health and Medical Psychology, School of Law, Psychology and Social Work, Örebro University, Sweden Abstract: Night terror is a rare problem in adults characterized by nighttime episodes similar to panic attacks except that sufferers are not aware of the content. There is no current treatment, but exposure is a treatment of choice for panic. The purpose of this case study was therefore to develop and describe a novel treatment. The client had a 22-year history of night terror attacks with verbalization causing sleep difficulties and daytime fatigue. A cognitive-behavioral package featuring exposure (listening to audio recordings of the episodes) and re-conceptualization was provided over 13 sessions. Results indicated a large decrease in the ratings of the intensity of the night terror episodes. Moreover, sleep onset latency decreased while sleep quality and duration improved substantially. The client reported important increases in daytime activities and resumed working. Although caution is necessary because this is a case study, the results suggest that this technique warrants further study for people suffering from night terrors. Keywords: Night terrors, adults, exposure therapy, cognitive behavioral treatment. INTRODUCTION insomnia [7, 8] and panic disorders [9, 10]. Indeed, exposure is a treatment of choice for panic attacks and theoretical Night terrors are rare among adults, but when they do should be effective for night terrors as well [11, 12]. -
Migraine and Tension Headache Guideline
Migraine and Tension Headache Guideline Major Changes as of May 2021 .................................................................................................................... 2 Medications Not Recommended for Headache Treatment .......................................................................... 2 Background ................................................................................................................................................... 2 Diagnosis Red flag warning signs ........................................................................................................................... 3 Differential diagnosis .............................................................................................................................. 3 Imaging ................................................................................................................................................... 3 Migraine versus tension headache ......................................................................................................... 4 Medication overuse headache ................................................................................................................ 4 Menstruation-related migraine ................................................................................................................ 4 Tension Headache Acute treatment ...................................................................................................................................... 5 Prophylaxis ............................................................................................................................................