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Does Sleep Apnea Cause Headaches?


Studies have shown that a headache on awakening occurs with 4-6% of the population, but a headache is present in 15-74% of people with sleep apnea. Headaches are either a migraine, cluster or tension headaches. People suffering from headaches have a 2 to 8 fold increased risk for sleep disorders compared to the general population.  Obstructive sleep apnea (OSA) is the primary cause of these headaches that can increase in frequency and severity. Headaches are based on neurophysiological mechanisms and neuroanatomical conditions of serotonin, melatonin and the hypothalamus.  A significant number of sleep apnea related headaches resolve or improve with the treatment of OSA with continuous positive airway pressure (cpap). A re-evaluation of headache symptoms should occur one month after the initiation of OSA treatment.

Related Research Studies

Maurice M. Ohayon MD found that a debilitating morning headache affected 1 in every 13 people. There was an increased risk in women, the unemployed, homemakers and people age 45-64 years. The key cause of the headaches was sleep apnea. In a study by N.K. Loh et al, 48 subjects with sleep apnea had morning headaches that lasted about 30 minutes. The frequency and severity of the headaches were directly correlated with the severity of their sleep apnea. Of the 29 subjects treated with cpap, eighty percent showed an improvement of their headaches.

St. John’s Providence Physician Network

OSA is associated with headaches caused by hypoxemia or reduced oxygen in the blood. Twenty percent of patients with OSA had dull headaches that were usually located in the bifrontal area of the brain above the eyebrows. These headaches lasted one to two hours after awakening in the morning. They did not exhibit symptoms of a migraine or atypical headache. Studies suggest that persons with moderate to severe OSA should be treated with nasal cpap to relieve headaches.

A European Study

At the 23rd European Neurological Society meeting, Hildegard Hidalgo MD reported on a finding that indicated 1 of 4 persons with sleep apnea will have a migraine headache. After treatment with cpap, the frequencies of migraines were reduced. Those that occurred were less intense and shorter in duration.

Studies from the University of Maryland Medical Center

Morning headaches are one of the symptoms of OSA. Persons with 15 or more episodes of apnea or hypopnea per hour have moderate sleep apnea. OSA is a possible underlying cause of chronic headaches. Some people treated for OSA cure their headaches. Two percent of children have OSA with morning headaches. OSA in children is diagnosed with failure to thrive, irritability, snoring and behavioral issues. The polysomnography can diagnose OSA in children and adults.




The American Headache Society; Jeanette C. Rains, PhD
Sleep Disorders and Headaches

St. John’s Providence Physicians Network
Medical Facts about Headaches and Sleep Apnea

Jefferson University Hospitals
Study: Treating Sleep Apnea Reduces Migraines

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