Cefaleias Primrias E Sua Relao Com O Sono
Fabiana Yagihara1 Ligia Mendonça Lucchesi1 Anna Karla Alves Smith1 José Geraldo Speciali2
ABSTRACT
There is a clear association between primary headaches and sleep disorders, especially when these headaches occur at night or upon waking. The primary headaches most commonly related to sleep are: migraine, cluster headache, tension type, hypnic headache and chronic paroxysmal hemicrania. The objective of this review was to describe the relationship between these types of headaches and sleep and to address sleep apnea headaches. There are various types of demonstrated associations between sleep and headache disorders, and the mechanisms underlying these associations are complex, multi-factorial and poorly understood. Moreover, all sleep disorders may be related to headaches to some degree therefore, the evaluation of patients with headaches should include a brief investigation on sleep patterns and related complaints. Patients with headache at night or upon waking who are resistent to the indicated treatment require formal polysomnographic evaluation to exclude a treatable sleep disorder.
Keywords: headaches, migraine disorders, obstructive, pain, sleep apnea, sleep disorders.
RESUMO
Palavras-chave: cefaleia, distúrbios do sono, dor, síndrome da apneia obstrutiva do sono, transtornos de enxaqueca.
INTRODUCTION
PRIMARY HEADACHES RELATED TO SLEEP
Migraine
Cluster headache
Tension-type headaches
Hypnic Headache
Chronic Paroxysmal Hemicrania
REFERENCES
What Makes Your Headache Better
- As mentioned above, dehydration or low blood sugar can cause headaches in the morning, so if having a meal seems to resolve your symptoms, thats a likely culprit.
- If coffee is what gives your headache relief, then it may be caused by caffeine withdrawal.
- Migraines are sometimes treatable with rest and by minimizing noise and bright lights.
- If you are on medication, stopping may ease the headache. Since you are likely on your medication for a specific reason, its extremely important to never stop taking any medicine without your doctors approval.
What Causes Morning Headaches
As you transition from sleep to wakefulness, parts of your brain start to wake up too. Your brain becomes more responsive to changes in your body position, touch, and sound. During this period of heightened sensitivity, you may be more susceptible to pain.
Additionally, the hypothalamus in the brain is involved in both sleep and pain processes. The hypothalamus regulates your natural circadian rhythms and sleep cycles and modulates sensation and pain. Disturbances in the hypothalamus during sleep affect your ability to tolerate pain. As a result, while you may not have felt pain as you slept, you may feel it in the morning.
Sleep disorders commonly trigger morning head pain, but there are numerous possible causes for waking up with a headache.
Read Also: Headache With High Blood Pressure
Do Brain Tumours Cause Headaches
Headaches are one of the most common symptoms of a brain tumour, but they are also common in healthy people, and can be due to many everyday causes.
The headaches are not caused directly by the tumour itself, as the brain has no pain receptors, but by a build-up of pressure on pain-sensitive blood vessels and nerves within the brain.
The build-up of pressure can be due to the tumour pressing on these vessels/nerves or by the tumour blocking the flow of cerebrospinal fluid within the brain.
Headaches are rarely the only symptom of a brain tumour.
Doctors do NOT generally worry if your headache is:
- occasional
- mild
- doesnt last long
- has an identifiable cause, such as a hangover, lack of sleep, flu-like illness, sinus infection or if you have been fasting or overusing medication.
However, people often worry whether their headache is due to something more serious, such as a brain tumour, particularly if they have frequent or severe headaches causing a lot of pain.
If youre worried, you should speak to your doctor, who can undertake a neurological examination. This involves testing your vision, hearing, balance, reflexes, arm and leg strength, and coordination. If this examination does not show anything outside the normal range and you have no other symptoms, you are unlikely to have a brain tumour.
Morning Headache: Why Youre Waking Up With Headaches
We all go to bed at night with intentions of waking up feeling rested, refreshed, and ready for the day. But for many people, waking up with a headache interferes with that.
Headaches are not uncommon and neither is waking up with them. There are several causes for waking up with headaches, and discovering the cause is the first step to putting a stop to them.
Recommended Reading: Foods To Eat For Headaches
Does Your Head Hurt
If youve experienced any of these problems for several days in a row, dont hesitate to consult your doctor. Its important for the professional to do a complete check-up to find out what may be happening to you and whats the most appropriate way to treat the issue so that you can regain your well-being and lead a normal life.
Night Sweats And Headaches: Possible Hypoglycemia
Hypoglycemia, or extremely low blood glucose, is one of the primary dangers facing diabetics. The risks posed by hypoglycemia may be especially worrisome if the condition occurs during sleep, when the diabetic patient is incapable of monitoring and immediately responding to a significant drop in blood glucose levels. This is why it’s important not only to take steps to prevent nighttime hypoglycemia, but understand and recognize symptoms and warning signs of the condition.
One of the earliest indicators that a diabetic may be experiencing hypoglycemia in sleep is chronic night sweats, as well as waking up with painful headaches. For those whose night sweats and morning headaches do not self-resolve within a few days, it may be wise to try a quick test.
Set your alarm for the middle of the night say 2 a.m. for a person who’s in bed by 11 p.m. Test your glucose levels and record the measurement, go back to sleep and test again immediately upon waking in the morning. If you begin to notice abnormal nighttime fluctuations during this exercise, it may be wise to consult your health care provider.
Causes Of Headache While Sleeping
Experiencing headaches while sleeping can be the start of a very frustrating journey since a good sleep quality is tantamount to being healthy and being able to perform well during the day. The reasons can range from drinking too much alcohol just before bedtime or being overly stressed out. The first step is to recognize the triggers that cause the headaches and subsequently avoiding them. If you continue to experience them even after avoiding the stressors, consult your doctor for a full evaluation.
Bruxism Or Teeth Grinding
Sleep bruxism, or teeth grinding or clenching during sleep, can make you wake up with a headache. This forceful and excessive movement also leads to tooth wear, muscle pain, and gum damage. Causes of sleep bruxism include having an irregularly shaped jaw, stress and anxiety, sleep disruption, alcohol use, and coffee.
A dentist can determine if you have sleep bruxism. Treatment often involves wearing a mouthguard at night. Your dentist may also prescribe drugs for pain management and recommend cognitive behavioral therapy to manage stress and anxiety.
How To Prevent Morning Headaches
As you can see, preventing morning headaches is mostly about understanding the root cause and taking steps to fix itwhether thats cutting back on drinking, getting a mouth guard to prevent grinding, or trying an elimination diet to find out which foods trigger morning headaches for you. If youve tried all of these things, and youre still waking up with a headache, its probably time to talk to your doctor. What you think is a run-of-the-mill headache could be migraine or another condition that needs more targeted treatment.
How To Treat Morning Headaches
The right treatment depends on whats causing your morning headaches. If you have migraine attacks, your doctor will probably recommend abortive medications like these, according to the Mayo Clinic:
- Nonsteroidal anti-inflammatory drugs , like ibuprofen or naproxen
- Triptans to calm overly active pain-sensing nerves
- CGRP antagonists relieve pain and symptoms like nausea and sensitivity to light as quickly as two hours after taking it
- Antiemetics to reduce pain and help with nausea and vomiting
- Ergot alkaloids such as Dihydroergotamine to shrink your blood vessels and lower inflammation
For tension-type headaches, OTC pain relievers can provide temporary relief, according to the Mayo Clinic, but youll want to identify the health condition or problem thats causing tension in the first place. For example, hunching over a laptop for 8-plus hours a day can lead to neck and shoulder pain that triggers a headache a physical therapist could help release those muscles and teach you how to improve your posture while working.
Other ways to treat morning headaches caused by tension include a warm or cold compress to ease the pain, a warm shower to relax tense muscles, or a massage to loosen trigger points.
Before talking to your doctor about your morning headaches, Dr. Shadbehr recommends keeping a log of them, addressing questions like these:
- When did it start?
When To Talk To Your Doctor
You should talk to your doctor if you start experiencing headaches that you did not experience before, if the headaches wake you from your sleep, or if your headaches change in any way, especially if they are severe. You should also contact a healthcare professional if your morning headaches are accompanied by any other symptoms, such as loud snoring, vomiting, or feeling tired during the day. In preparation for your doctorâs visit, consider keeping a journal next to your bed to record the frequency and intensity of your morning headaches.
Your doctor can run tests to see if you might have a treatable sleep disorder or other medical condition. They can also work with you to change your medications and implement productive lifestyle habits to help reduce morning headaches.
Brain Tumor Vs Sleep Apnea Headaches
Both brain tumors and sleep apnea can be associated with morning headaches, begins Joseph Krainin, MD, board certified in sleep medicine and neurology and founder of the online sleep apnea clinic Singular Sleep.
However, its important to keep in mind that the mechanism is different, continues Dr. Krainin.
Brain tumors take up room inside the skull and create increased pressure. When you lie down, intracranial pressure increases naturally, but, if youre healthy, you dont notice it.
A brain tumor can compound this normal effect and cause a headache.
A brain tumor also causes fluid buildup overnight that, come morning, can result in a headache.
Therefore, headaches related to brain tumors are more positional than sleep-related its lying down that sets them off, says Dr. Krainin.
Sleep apnea-related headaches are due to the negative physiological consequences of the abnormal breathing events.
When a person has untreated sleep apnea, their brain is subjected to repeated incidents of subnormal oxygen levels called hypoxic events.
The brain desperately needs oxygen continuously. Imagine that for eight, even five hours overnight, this supply repeatedly dips sometimes dozens of times per hour.
Sleep apnea. Habib Mhenni, Wikimedia Commons
No wonder many people with untreated sleep apnea awaken to a headache nearly every morning or even in the middle of the night. It typically lingers for half an hour or so after getting out of bed.
What Is The Treatment For Sleep Apnea
Many people who suffer from this condition look for credible and effective sleep apnea treatment. If youre one of those who experiences headaches due to sleep apnea, continuous positive airway pressure or CPAP can be extremely helpful. This device decreases the frequency, intensity, and occurrence of headaches. As soon as people start CPAP therapy, many find that their morning headaches disappear altogether.
Morning Headaches: Why Am I Waking Up With Headaches
Do you often have a headache when you wake up? Every 1 out of 13 people wakes up with headaches. Generally, morning headaches affect women more than men and are frequently associated with the 45 to 64 age group. A pounding headache, that too in the morning makes it more challenging to get up from your bed.
What causes headaches? There can be many reasons for morning headaches everydayhealth problems, eating habits, lifestyle, to name a few. Continue reading to learn everything about waking up with a headache.
Reasons You Wake Up With A Headache Every Morning And How To Get Rid Of Them
Do you find yourself waking up with headaches in the morning? Are you waking up with a headache every morning? Then youve got some digging to do. Morning headaches are very common, and usually, they dont just happen out of the blue. That throbbing pain in your head likely has an underlying cause, and to get rid of your morning headaches, youll need to figure out whats triggering them.
To get you started, here are 10 of the most common culprits behind morning headaches and what you can do to alleviate them.
What Are Hypnic Headaches
Hypnic headaches are a rare type of headache that occurs during sleep and wakes the person up, which is why theyve earned the nickname alarm-clock headaches. The pain can keep people up for at least 15 minutes, if not longer. People who experience hypnic headaches typically have them several times a week.
When Are Morning Headaches More Serious Which Diseases Are Associated With Morning Headaches
- The diseases most commonly associated with headaches are meningitis, an infection of the spinal cord, or a brain tumor. Shingles can also trigger a headache.
- Other possibilities include trigeminal neuralgia , aneurysm, temporal arteritis, or other autoimmune disorders.
- None of these cause headaches in the morning specifically, and all can cause bad headaches, at any time of day.
What Causes A Hypnic Headache
Hypnic headaches are considered a primary headache disorder, which means they are not caused by a known underlying condition. Beyond that, researchers dont know for sure what causes hypnic headaches.
Hypnic headaches often occur during rapid eye movement sleep, so its possible that an area of the brain involved with processing pain gets activated, leading to a hypnic headache.
Hypnic headaches may also be linked to melatonin production. Melatonin is a hormone that makes you feel sleepy, and its production levels rise and fall throughout the day in line with your sleep-wake cycle. Because hypnic headaches occur at the same time each night, some researchers believe there may be a disturbance to the underlying rhythms that regulate melatonin production, which causes lower melatonin levels and, subsequently, hypnic headaches.
Part of the evidence supporting this theory comes from the efficacy of lithium in treating hypnic headaches, since lithium is effective in treating other chronobiological disorders and helps increase melatonin levels.
How Can I Stop Waking Up With A Headache
A morning headache from time to time probably isn’t reason to worry. But see your doctor if:
- You get morning headaches several times a week
- They’re really painful
- You have other symptoms like snoring or dizziness with them
Which treatment your doctor recommends depends on the cause of your headaches. You may need medicines to prevent migraines and cluster headaches. You can also take a pain reliever first thing in the morning to stop a headache that has already started.
Sleep apnea treatment includes a CPAP machine that pushes air into your lungs while you sleep. Other sleep apnea devices keep your throat open to help you breathe.
If you grind your teeth while you sleep, ask your doctor whether you should wear a mouth guard to prevent you from clenching. Also, try meditation or other relaxation techniques. Daytime stress can contribute to nighttime grinding.
Use pain relievers sparingly and only when you need them. Overuse of these medicines can lead to rebound morning headaches.
To sleep longer, get into a routine. Go to bed at the same time each night and wake up at the same time each morning. Avoid alcohol and caffeine around bedtime because they can keep you awake.
How Can Nighttime Oxygen Therapy Cause Morning Headaches4
Some people with COPD need to have oxygen therapy during the night. This means that they receive small amounts oxygen constantly through a mask over their nose and face or a small tube in the nostrils. If the amount of oxygen that the person is getting overnight is slightly too high, then this can cause a headache in the morning.
Are There Ways To Prevent Morning Headaches34
If the morning headaches are due to oxygen therapy, then having a healthcare provider adjust the amount of oxygen the person receives during the night can usually solve the problem.
If the morning headaches are the result of nighttime breathing problems caused by COPD, there are ways to manage the headaches by improving the persons nighttime airflow. Some treatments that may help include:
- Using prescribed COPD medicines to help reduce swelling in the airways
- Using the right kind of pillow to keep the head in the best position for breathing
- Exercising to improve overall lung function
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When To See Your Physician
If the headache goes on for a couple of weeks without improvement, or is associated with another neurological symptom, such as weakness on one side of the body, it is recommended to discuss your symptoms with a physician.
Headaches that are new or worsening, especially in a person who doesnt normally have headaches, may warrant a medical follow-up, as do headaches that are worse in the morning or when the person is laying down. These headaches could also potentially wake someone from their sleep, or be accompanied by nausea or vomiting.