What are the other Names for this Condition? (Also known as/Synonyms)

• Sleep Apnoea Headache

What is Sleep Apnea Headache? (Definition/Background Information)

• Sleep Apnea Headache is a headache disorder that occurs secondary to sleep apnea. The headaches are typically present in the mornings (on awakening) and involve both sides of the head. The affected individuals do not present nausea or an increased sensitivity to sound/light
• Sleep Apnea is a cessation (stoppage) or near cessation of respiratory airflow lasting 10 seconds or longer during sleep. The term apnea indicates a pause in breathing
• The Sleep Apnea Headaches may last for 4 hours or less and tend to resolve completely with adequate treatment. The cause of formation of these headaches is not well-understood, but it may be due to:
  • Sleep disturbances
  • Hypoxia - when there is a lower than normal level of oxygen in one’s blood
  • Hypercapnia - when there is too much of carbon dioxide buildup in one’s bloodstream, due to hypoventilation

The criteria for diagnosis of Sleep Apnea Headache as outlined by the International Headache Society (IHS) is given below:

• Sleep apnea with apnea-hypopnea index 5 or more has been diagnosed
• Headache present on awakening after sleep and fulfilling the criterion below

Evidence of causation demonstrated by at least two of the following:

• Headache has developed in temporal relation to the onset of sleep apnea
• Either or both of the following:
  • Headache has significantly worsened in parallel with worsening of sleep apnea
  • Headache has significantly improved or remitted in parallel with improvement in or resolution of sleep apnea
• Headache has at least one of the following three characteristics:
  • Recurring on 15 or more days/month
  • All of the following - bilateral location, pressing quality, and not accompanied by nausea, photophobia, or phonophobia
  • Resolving within 4 hours

Not better accounted for by another ICHD-3 diagnosis.

(Source: International Headache Society Classification ICHD-3, London, United Kingdom)

A differential diagnosis to exclude the following sleep-related conditions may be necessary:

• Chronic obstructive pulmonary disorder (COPD)
• Periodic leg movement
• Pickwickian syndrome

Performing an overnight polysomnography test is important towards establishing a definitive diagnosis of Sleep Apnea Headache.