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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Modern sleep research studies have provided the practicing physician with considerable new information concerning the basic psychophysiology of sleep, the effects of medical conditions on sleep and the role of maturational and emotional factors in producing certain sleep disorders. Medical and psychiatric disorders, sleep disorders and drug-induced sleep stage alterations are studied in the sleep laboratory using the same techniques developed to analyze sleep patterns in normal subjects. After initial sleep laboratory adaptation, a profile of the sleep characteristics of various clinical conditions is obtained. This profile can be compared to sleep profiles of normal subjects as well as to the effects on sleep of subsequent experimental or therapeutic procedures. Various studies have shown that coronary artery, duodenal ulcer and nocturnal headache patients experience angina, increased gastric acid secretion and migraine or cluster headaches, respectively during REM sleep. Adult nocturnal asthamtic episodes occur out of all sleep stages while attacks of dyspnea in asthmatic children occur in all stages except stage 4 sleep. Hypothyroid patients show decreases in stages 3 and 4 sleep, while in hyperthyroid patients the percentage of time spent in stages 3 and 4 sleep is markedly increased. Enuretic episodes occur predominantly in non-rapid eye movement (NREM) sleep. Sleepwalking and night terror episodes occur exclusively out of NREM sleep, particularly from stages 3 and 4 sleep. Most child somnambulists and children with night terrors "outgrow" this disorder, suggesting a delayed maturation of the central nervous system. Stimulant drugs are effective in the treatment of the sleep attacks of narcolepsy and in treating certain cases of hypersomnia, while imipramine is an effective treatment for the auxillary symptoms of narcolepsy. Psychological disturbances are frequent in adult somnambulism and night terrors as well as in hypersomnia and insomnia. Proper pharmacologic treatment to provide symptomatic relief for insomnia is recommended to enhance the psychotherapeutic process.
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PMID:Nocturnal psychophysiological correlates of somatic conditions and sleep disorders. 77 62

A patient who first presented with episodic cluster headache later developed narcolepsy. In spite of REM sleep alterations associated with narcolepsy, the frequency and distribution of pain attacks did not change when narcolepsy occurred and were similar to those seen in cases of episodic cluster without narcolepsy. The lack of influence of narcolepsy on the pattern of cluster pains questions the role of REM sleep states in triggering pain in episodic cluster.
Cephalalgia 1991 Jul
PMID:Episodic cluster headache and narcolepsy: a case report. 188 66

The effect of zolpidem 10 mg p.o. on sleep in patients with persistent psychophysiological insomnia was assessed by polysomnographic recordings. An improvement in sleep with no rebound insomnia was observed during treatment for two weeks. Time awake after the onset of sleep was reduced after one week and increased after two weeks, whereas sleep latency remained reduced. Zolpidem markedly increased the duration of Stage 2 sleep without affecting either slow wave sleep or REM sleep. Subjective evaluation of improvement in sleep was well correlated with sleep laboratory findings. Zolpidem did not impair the immediate memory or psychomotor performance of patients on the morning after its administration. Side-effects during the period of drug administration included drowsiness, fatigue, headache, anxiety and irritability. They were mild or moderate and wore off soon after awakening.
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PMID:Effect of zolpidem on sleep in insomniac patients. 266 41

Profound transient nocturnal hypoxemia is common during REM sleep in "blue bloaters" with chronic obstructive lung disease, these patients having hypoxemia and CO2 retention when awake, when breathing air. These hypoxemic episodes appear to be due to a combination of reduced ventilation in REM sleep with a possible increase in the maldistribution of ventilation to perfusion within the alveoli at that time, and a reduction in functional residual capacity. The episodes are associated with exacerbations of pulmonary vasoconstriction, which can be reversed by oxygen therapy throughout sleep. Cardiac arrhythmias and alterations in ST segments are also found in these patients during sleep when breathing air. It is probable that the severity of hypoxemia in REM sleep can be predicted from knowledge of the arterial PO2 when breathing air when awake in patients with COPD. If so, expensive sleep studies are not essential to indicate the presence of hypoxemia in sleep in these patients, but such studies may be required in obese patients, in those who snore, or those who complain of headache following nocturnal oxygen therapy to demonstrate the presence of the overlap syndrome, in which obstructive sleep apnea is combined with chronic obstructive lung disease in the same patient. Nocturnal oxygen therapy may be dangerous in such patients with the overlap syndrome but appears to cause little rise in PCO2, in patients with COPD and REM-associated hypoxemia alone. Hypoxemia and sleep quality can probably be improved by oxygen therapy in "blue bloaters," and this treatment can also reverse pulmonary hypertension in REM sleep. The new ventilatory stimulant almitrine can also correct hypoxemia, without disturbing sleep quality, but the effects of this drug on pulmonary vasoconstriction during REM sleep are as yet unknown.
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PMID:Sleep in chronic obstructive lung disease. 293 59

Mazindol, a new anorexiant, was administered at a daily dose of 0.5-4 mg to 10 narcoleptic subjects aged 21-63 years. All the patients suffered from sleep attacks and one or more of the REM-related symptoms. Eight patients received only mazindol, and two patients received mazindol simultaneously with clomipramine or flurazepam. Sleep attacks were reduced in nine patients, and cataplexy was also markedly reduced in four patients. Mild adverse reactions were reported in six patients: two patients complained of headache, four of nocturnal sleep disturbance, and two of reduced appetite. Most side effects disappeared spontaneously or after dose reduction, and none of the patients had to stop medication. The results suggest that mazindol is effective not only for sleep attacks but also for cataplexy. It is recommended as a treatment for mild cases of narcolepsy.
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PMID:Therapeutic effects of mazindol on narcolepsy. 370 52

Twenty-three narcoleptic subjects participated in a single-blind drug study with placebo-viloxazine hydrochloride (100 mg/day). One woman discontinued the study because of nausea and headaches during the treatment period. The remaining 22 subjects were polygraphically monitored during baseline, The remaining 22 subjects were polygraphically monitored during baseline, placebo intake, viloxazine treatment, and placebo intake following 48 h of drug withdrawal. Symptoms and side effects were evaluated subjectively and objectively. Except for the subject who discontinued the study, viloxazine was well tolerated, particularly in elderly subjects. The drug had an inhibitory effect on REM sleep, cataplexy, and other auxiliary symptoms. While there is no objective evidence that it heightens alertness, patients reported fewer sleep attacks.
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PMID:Viloxazine hydrochloride in narcolepsy: a preliminary report. 370 53

We observed acute confusional migraine (ACM) attacks in two adolescents, and in both cases the episodes ended when the patients fell asleep spontaneously. Laboratory and neuroradiologic examinations were unremarkable. The post-ictal polysomnograms displayed a regular quality and duration of the physiologic components of sleep. Random posterior slow waves occurred only during the nocturnal awakenings and REM periods. The observation that sleep may resolve migraine attacks is emphasized. ACM is characterized by peculiar and relatively quickly reversible clinical manifestations and EEG abnormalities. The lack of significant abnormalities in post-ictal polysomnograms corresponds to a functional integrity of the brainstem structures involved in the global organization of sleep and may represent a useful laboratory feature in the diagnosis of ACM.
Cephalalgia 1986 Jun
PMID:Acute confusional migraine attacks resolved by sleep: lack of significant abnormalities in post-ictal polysomnograms. 374 94

The effect of the nootropic drug, piridoxilate on normal and on exogenously (by traffic noise) disturbed sleep and awakening quality was investigated in a double-blind placebo-controlled study. 10 elderly subjects with a mean age of 62 years spent 13 nights in the sleep laboratory: 2 adaptation nights, 1 baseline night, 3 drug nights (placebo, 300 and 600 mg piridoxilate), as well as 2 drug nights with nocturnal traffic noise (placebo and 600 mg piridoxilate) and the subsequent wash-out nights. Polysomnographic recordings (including EEG, EMG and EOG) were carried out between 10:30 p.m. and 6.00 a.m. Traffic noise was pre-recorded at a busy Viennese street and presented continuously by a loudspeaker with a sound pressure level at the ear of between 68 and 83 dB (A) [mean 75.6 dB (A)]. In the morning the subjects completed a sleep questionnaire for the subjective evaluation of their quality of sleep and awakening. Thereafter objective awakening quality was measured by a psychometric test battery. Piridoxilate did not induce any significant changes in objective and subjective sleep variables. Nocturnal traffic noise produced a decrease in total sleep time and sleep efficiency, an increase in wakefulness and drowsiness (stage 1), as well as a decrease in REM and deep sleep stages, the last-mentioned being of statistical significance. Subjectively, the elderly subjects reported a deterioration in sleep quality due to traffic noise, an increase in middle and late insomnia, as well as a deterioration in awakening quality (dizziness, tiredness, headaches). Piridoxilate did not ameliorate these sleep disturbances.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Effect of nootropic drugs on normal and disturbed sleep of the elderly: controlled studies with pyridoxilate and street noise]. 639 69

A 68-year-old man with chronic lung disease suffered from cluster headache (CH)-like pain associated with an upper cervical meningioma extending to compress the lower brain stem. The pain disappeared after tumour excision. We suggest that compression of the brain stem and hypoxemia associated with chronic lung disease might have caused the attacks, especially in the early morning when REM sleep hypoxia was prevalent.
Cephalalgia 1984 Sep
PMID:Cluster headache-like pain caused by an upper cervical meningioma. 649 32

In order to evaluate autonomic nervous system changes occurring before nocturnal headache attacks, we studied three subjects (one male, two females) suffering from chronic migraine. All three patients underwent a nocturnal polygraphic recording including continuous monitoring of systemic arterial pressure and heart rate. Two subjects showed increases and irregularities of arterial pressure before awakening with headache. These changes began during N-REM sleep and lasted during REM sleep preceding the awakening with headache. Heart rate did not change before the attacks. These findings do not support the hypothesis that autonomic instability during REM sleep represents the precipitating factor of the attacks.
Cephalalgia 1983 Aug
PMID:Nocturnal headache: systemic arterial pressure and heart rate during sleep. 661 9


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