The Diagnosis and Treatment of a Sleep Apnea Headache

Do you suffer from a headache when you wake up in the morning? Do you also find yourself dozing off multiple times throughout the day? Does your partner report episodes of snoring at night? You may be suffering from a medical condition called Obstructive Sleep Apnea (OSA).

Let's review the basics of what OSA is and the morning "sleep apnea headache" that may accompany it.

What Is Obstructive Sleep Apnea (OSA)?

OSA is a medical condition characterized by frequent nighttime awakenings due to abnormal breathing during sleep. People with OSA have episodes throughout the night where they either stop breathing or breathe shallowly, causing low oxygen levels.

As a result of this disorder, people with OSA often report excessive daytime sleepiness, thinking problems, and morning headaches. The diagnosis of OSA is made by a sleep specialist after a patient undergoes an overnight sleep study.

What Is a Sleep Apnea Headache?

According to the classification criteria of the third edition of the International Classification of Headache Disorder (ICHD-III), a sleep apnea headache is a recurrent morning headache in a person who has been diagnosed with sleep apnea. A headache has one or more of the following features:

• Occurs more than 15 times a month.
• Occurs on both sides of the head, has a pressing quality, and is not associated with nausea, photophobia, or sensitivity to sound. 
• A headache resolves within 4 hours

Before making the diagnosis, your healthcare provider will take a thorough history and perform a careful physical examination to make sure there is not another cause for your headaches, especially since multiple medical conditions can cause morning headaches. Examples of conditions that may cause a morning headache include:

• Restless Leg Syndrome (RLS)
• Chronic Obstructive Pulmonary Disorder (COPD)
• Obesity Hypoventilation Syndrome (Pickwickian Syndrome)

The Science

The precise "why" behind a sleep apnea headache is not fully understood. It may be due to the actual sleep disturbance. Or, the headache could be triggered by the low oxygen and high carbon dioxide levels that occur during the repetitive episodes of apnea.

Treatment

Treatment of a sleep apnea headache entails treating the primary disorder, OSA. Sleep apnea is usually treated with a variety of interventions including weight loss, continuous positive airway pressure (CPAP), upper airway surgery, and treatment of nasal allergies.

What This Means for You

If you think you suffer from a sleep apnea headache, please speak with your healthcare provider. The good news is that there are effective therapies out there for your sleep apnea and your morning headaches. Also, with treatment, you will likely find that you feel better and improve other health parameters, besides just your headaches.