Sleep apnea is known to cause a lot of issues; from sleeping deprivation, snoring to increased risk of pulmonary and cardiovascular diseases.
However, it seems that the cases of sleep apnea-induced migraines are increasing among the general public that suffers from obstructive sleep apnea. Even though headaches have always been associated with sleep deprivation, and breathing difficulties, migraine attacks are a relatively new concept when it comes to OSA.
But, even now, scientists and doctors are confused by whether these are migraines, or simply sleep apnea headaches. So far, headaches are the most common effects of OSA, but migraines aren’t really.
So, can sleep apnea really cause migraine attacks, or are we just talking about headaches? In the following paragraphs we’ll take a look at the potential connection between OSA and migraines, so let’s get started!
Headaches Vs. Migraines – Overview
To understand the potential relationship between sleep apnea and migraines, we must first determine the difference between headaches and migraines. This will help us paint a bigger picture of what these syndromes and effects are, in regards to sleep apnea.
Tension headaches are often associated with stress, fatigue, and strain, and are considered to be primary headaches. These headaches are generally associated with activities that put tension on the head and the neck. Some of the most common triggers of tension headaches are teeth grinding or bruxism, extensive reading, computer work, gum chewing, lack of sleep, poor posture, depression/anxiety, etc. Some of the most common symptoms of tension headaches include;
- Dull, steady pain that is mild in intensity,
- Pain felt in the forehead, temples, back of the neck or throughout the head,
- Muscles in the back of the neck and the upper neck are usually tender to touch and may feel knotted,
- Symptoms usually subside within a few hours but may require some over-the-counter anti-headache medication.
Alongside tension headaches, there are also cluster headaches. The symptoms of cluster headaches are generally more severe. Cluster headaches mean that a person is experiencing several headaches at the same time, usually every day. Unlike other headaches and even migraines, cluster headaches tend to last between 6 and 12 weeks. The symptoms generally include;
- Severe and persistent pain on only one side of the head,
- Pain behind the eyes, which are generally red and watery,
- Excessive sweating,
- Excessive restlessness, agitation, and anxiety,
- Increased heart rate,
- Congestion, etc.
Note: There are also other types of headaches, like hemicrania (accompanied by nausea, vomiting, sensitivity to light and sound, irritated, red and watery eyes, etc.), as well as secondary headaches.
These headaches are generally associated with sleep disorders, illnesses, or chronic conditions that affect the nervous system.
Now, migraines are a type of primary headaches. However, migraines differ from other types of primary headaches in that they cause attacks or episodes. Headaches seem to be just the starting point of migraines, where the headache symptoms become more intense and the pain is throbbing. Migraine attacks can last anywhere between a few hours to even a few days. Migraine symptoms include;
- Nausea and/or vomiting,
- Sensitivity to light, or photophobia,
- Sensitivity to sound or phonophobia,
- Scalp tenderness,
- Pale skin color,
- Cold hands, etc.
Other migraine symptoms can include mood swings, food cravings, tenderness of the neck area, blurred vision, and in the most severe cases, even slurred speech and inability to understand what other people say. That is why migraine attacks are considered dangerous and people with these attacks are recommended immediate treatment, enough sleep, and rest.
Migraines And Sleep Apnea
A study, conducted regarding the connection between migraines and sleep apnea, shows that there is a significant association between sleep apnea and headaches. It seems that the most common cause of headaches in sleep apnea patients is sleep deprivation. Sleep apnea is considered to be a sleep disorder where there is an obstruction of breathing, causing people to experience airflow cessation. This leads to restless sleep, sleep deprivation or insomnia, fatigue, lack of oxygen in the body, and of course, headaches.
These headaches are generally considered to be sleep apnea headaches. They are recognized as such in the International Classification of Headache Disorders (ICHD). Sleep apnea headaches are recurrent morning headaches that appear in sleep apnea patients. However, there is an issue regarding the association of primary headaches or migraine attacks with sleep apnea. Sure, the apnea-related headaches may appear as migraine, tension-type, or cluster headaches. But, studies show that these are simply a non-specific symptom and have no clear relationship with obstructive sleep apnea.
So, to be more specific, according to the current finding, sleep apnea-related headaches are surely recognized as such, but these headaches have no connections to migraine attacks or episodes. Studies also show that, for example, snorers have a higher prevalence of migraine attacks than people with sleep apnea syndrome. Not to mention that there also seems to be a higher prevalence of migraines in people without sleep apnea than among OSA patients.
Sleep Apnea Headaches Explained
As mentioned before, sleep apnea headaches are recurrent morning headaches associated with obstructive sleep apnea. Alongside daytime sleepiness and snoring, these headaches are one of the most common symptoms of OSA. People often confuse these headaches with migraine attacks, but these headaches differ from migraine attacks, and here’s how;
- Migraine attacks are felt on only one side of the head, while sleep apnea headaches are felt on both sides.
- Migraine attacks can last for hours or days, while sleep apnea headaches dissipate usually within a few hours after waking up.
- Migraine attacks usually don’t reoccur, unless you’re exposed to the same triggers constantly or you’re having serious underlying issues. On the other hand, sleep apnea headaches reoccur regularly in sleep apnea patients.
However, some studies show that there are patients with sleep apnea headaches that exhibit the same characteristics as migraines or tension-type headaches. It is believed that sleep apnea treatment, using CPAP, BiPAP, or APAP machines can cure these types of headaches, mitigate the symptoms, or prevent them from occurring at all.
Nevertheless, the studies about sleep apnea headaches are rather scarce and require a more thorough insight into the causes and effects these headaches have in regards to OSA. So far, the cause of sleep apnea headaches remains uncertain, but sleep deprivation, oxygen shortage, and snoring are surely some of the contributors.
How To Treat Sleep Apnea Headaches?
CPAP therapy is currently the best treatment option for sleep apnea, but it seems to also help with the morning sleep apnea headaches. Studies show that nasal CPAP therapy improves the headaches and symptoms dramatically in both, children and adults since it provides enough oxygen for the brain. However, for patients to experience this improvement, they need to get proper sleep.
One way of getting proper sleep is through regular sleep hygiene. It is important to take in vitamins, magnesium, and sometimes even melatonin-rich food or melatonin supplement.
Moreover, for sleep apnea and headache-prone patients, it is important to improve the sleeping environment, avoid using gadgets before bedtime, and try taking a calming shower before bed. It is also essential to air out the bedroom regularly and allow fresh air to come in. This will all contribute to better sleep quality, so the CPAP machine can do its thing and cure your morning headaches.
Lifestyle and Dietary Changes
Weight loss is essential when it comes to sleep apnea. But, it also seems to be essential in regards to headaches and migraines. Studies show that people with excessive weight are more likely to develop different types of headaches and migraines. Sleep apnea patients usually struggle with weight gain as well, so weight loss would be effective concerning both problems.
So, what you can do is introduce some dietary and lifestyle changes to lose weight. Try eating more vegetables, fruits, nuts, lean meat, and healthy fats. You can check out some of the world’s most healthy diets, like the Mediterranean diet, or some of the healthiest cuisines, like Greek, Italian, Japanese, Indian, Spanish, or South Korean.
These diets and cuisines are based on veggies, lean meat, and healthy fats; they will not only help you lose weight but also deal with sleep disturbances and improve the immune system. Healthy diets also lower the chances of cancer and cardiovascular diseases.
Moreover, it is essential you stay active. Physical activity and regular exercise will have you lose weight fast and healthy. It is also great to stay active because it helps your CPAP treatment have better effects. Regular training improves the health of your lungs and strengthens the muscles in your whole body, especially the ones necessary for proper breathing. Exercise is also known to lower headache risk or to mitigate the symptoms as well.
Change Of Sleeping Position
Certain sleeping positions cause morning headaches. Improper sleeping positions strain the muscles that support the neck, which usually cut oxygen flow to the brain and cause terrible morning headaches. The worst sleeping positions that cause headaches are;
- Curled up or fetal position – in this position, your shoulders are pushed forward. This can cause incredible tension to the neck muscles, which locks your neck position and limits the oxygen flow to the brain. Not to mention that this position is not preferable if you’re receiving CPAP therapy and you’re wearing a CPAP mask.
- Sleeping on the stomach – this is generally the worst sleeping position. The whole body is an unnatural position, and there are tension and pressure in all the prominent points in the body. The tension is especially increased in the shoulder and neck area because the head and the neck are twisted weirdly.
To lower the risk of sleep apnea causing the headache, make sure to sleep in a proper sleeping position, like;
- Sleeping on the back – even though this position is rather uncomfortable for the majority of the people, it is also the healthiest. Your spine, neck, and head are in perfect alignment and there is no unnecessary pressure on the neck and the shoulders. The oxygen flows freely to the brain, lowering the chances of morning headaches.
- Side sleeping – sometimes side sleeping is considered to be a good sleeping position, but under one condition. You need to have proper head elevation and knee position, to ensure that there is no tension in the body. Using proper pillows is essential for this position to prevent neck strain and shoulder tension.
In short, if you’re experiencing morning headaches, they are likely to be connected to your sleep apnea for sure. But to say that sleep apnea causes migraine attacks is too far fetched for now.
There aren’t enough studied to support this possibility, and so far, there hasn’t been any direct correlation between these two. Sleep apnea headaches are a real problem, but they are not migraines.
They have different symptoms and they manifest differently compared to migraine attacks. If you’re concerned about your headache and migraines problem, make sure to contact your doctor or sleep specialist for more information.