IMPORTANT, Migraines and REM sleep, please read

Hello! My name is Jane and I am new to the group but I wanted to share this with you all, in case it can be of help to you or someone you know who is in pain. I have been suffering with daily headaches/migraines for four years now. Since I am a young, petite female, nobody suspected I had sleep apnea, even though I complained about always being tired and take naps 1-2 times a day.

Want to take a scary trip around the milky way with me? Try the gamut of 14 different migraine preventatives that my neurologist prescribed, with side effects that ranged from neuropathy and fainting, to forgetting how to drive to work. Since most of them had the lovely side effect of fatigue as well, they all made my head hurt worst. After learning that 70% of all chronic migraine sufferers have a sleep disorder, I have to wonder, why didn't my neurologist immediately order a sleep study for me when I started seeing him? ****HINT $$$$****

I'm a medical professional myself, so I wanted to share these studies I found with you. My sleep apnea is most severe during REM, which is linked to chronic migraines. If you know of anyone with a condition like mine, please pass this on. Knowledge is power!!

This one explains why a lack of REM causes migraines:
https://www.psychologytoday.com/blog/sl ... e-proteins

This refers to a study where CPAP reduces migraines. I would post the study but I don't want to pay for it:
https://blog.easybreathe.com/cpap-study ... ty-burden/

Anecdotal stories of CPAP getting rid of migraines:
https://www.respshop.com/blog/2016/02/2 ... ache-free/

https://healthunlocked.com/migrainecent ... ap-therapy

Lastly, if you have/had migraines or headaches, please post if CPAP has helped you. I'm in the beginning stages of treatment and trying to find a mask that works for me. The lack of sleep during this adjustment period is making my head hurt worst, and I could really use some success stories for encouragement!

The headaches most of us get pre-Cpap are NOT migraines. They are pressure like, but short-lived, usually going away within a couple of hours after awakening. Of course some may have stronger and longer ones than others, but they are basically the result of low 02, high BP (which tends to come down once on Cpap) etc. Their origins may be similar to true migraines, but don't usually ever reach the level of pain or length of time and don't have auras. Lack of sleep may trigger migraine protein problems, but that's a different story. And anecdotal evidence of anything is not usually considered in the same way as true research. And using the terms 'headache' and 'migraine' interchangeably, randomly should not be done. They are not the same thing.

Hi, Jane,
I also have migraine almost all my life. I am also petite. A couple of the reasons may be due to my TMJ and work. I am a systems engineer working on computer or plant all day long. My sleeping pattern is awful even before using cpap, so I am very sensitive to whatever it may triggers migraine. I didn't dream much before I started using cpap (only 2 and half moths now), it may be because my body alert me not going to REM to prevent sleep apnea. I found out I am dreaming more now after using cpap. I am easy to get headache so less strap on my head and face is better. Had tried the amara view full face mask, can't sleep at all, and it leaked like crazy since I had to keep it lose otherwise will get headache. Then tried the nuance gel nasal pillow, can't sleep either since too noise. Now I use the air fit p10 nasal pillow, at least can get me sleep a couple of hours, less headache. But the nasal tip is too hard sometimes it makes my nose very un-comfortable, and hard to sleep. So I am waiting to try the f and p brevida in June when I can get a new mask. I also use "my pillow" place in a flat pillow, it looks like a 15 degree ankle to prevent headache. I did the research, flat pillow is never good for people with migraine pb.

Julie wrote:The headaches most of us get pre-Cpap are NOT migraines. They are pressure like, but short-lived, usually going away within a couple of hours after awakening. Of course some may have stronger and longer ones than others, but they are basically the result of low 02, high BP (which tends to come down once on Cpap) etc. Their origins may be similar to true migraines, but don't usually ever reach the level of pain or length of time and don't have auras. Lack of sleep may trigger migraine protein problems, but that's a different story. And anecdotal evidence of anything is not usually considered in the same way as true research. And using the terms 'headache' and 'migraine' interchangeably, randomly should not be done. They are not the same thing.

Wow, who tied a knot in your hose?! I'm looking for some encouragement and support, not nitpicking. When I said "headaches/migraines" I meant that I get both, not that they're the same thing. Kind of weird that you're pointing that out anyway, who cares, many OSA suffers get both? I'm not going to waste my afternoon arguing about the evidence I posted either, since I referenced anecdotal evidence IN ADDITION to several scientific studies. Go find someone else to harass, you're not ruining my day

mibbim,

I am also quite petite (5'1" and 112 pounds right now). I have had a lifelong struggle with TMJ, migraines, and tension headaches. The first several months of PAPing made the TMJ and migraine issues significantly worse for me because I was struggling so hard to get to sleep each and every night.

At the time I was doing my CBT-I, I was also (finally) addressing the fact that my migraines had become chronic to the point where they were definitely affecting the quality of my life. And I was also busy chewing through a brand new night guard made by my dentist.

Things really started to turn around for me after three things happened:

(1) The CBT-I brought the CPAP-inhanced insomnia under control.

(2) The chronic migraines were finally brought under control. The PA in the headache doctor's office started reading the insomnia sleep log and realized that as many problems as I had with topiramate, lamictal, and depakote, that it was time to try a very different approach with the migraines. She ordered a genetic test for MTHFR anomalies. After one was found, she put me on a prescription vitamin called Deplin, which contains a megadose of the metabolized version of folate, which my body apparently does not process well because of the MTHFR problem. She also encourgaged me to take a 400mg of riboflavin and 400-500 mg of magnesium daily, both in a divided dose. The vitamins (including the Deplin) brought the migraines under control for several years. Recently when the migrainous vertigo came back, the headache doctor suggested that I try a tiny dose of verapamil (a blood pressure medication) in addition to the vitamin regimen, and that seems to be doing the trick now.)

(3) The TMJ problems were finally brought under control by a TMJ dentist. My regular dentist decided that my TMJ problems were anything but normal after I essentially chewed through a new nightguard in less than 3 months. So he referred me to a specialist in TMJ. It wasn't cheap and it took time, but the TMJ guy designed several months worth of intense treatment using night guards. Eventually he wound up doing an additional set of tests that allowed him to figure out how to make me a night guard that I would not demolish in less than 6 months. That guard turns 3 years old this summer and it's still in good shape. AND my TMJ remains pretty much under control.

I tell you all that so that you have some sense of why I make the comments I do in regards to things you wrote in your post.

mibbim wrote: I also have migraine almost all my life. I am also petite. A couple of the reasons may be due to my TMJ and work.

TMJ and migraines can definitely feed each other. Clenching teeth can lead to a migraine. And a migraine can also cause you to clench your teeth.

Do you use a custom TMJ guard when you are sleeping? If not, you really should ask your regular dentist about the TMJ stuff. For most people, the guard that a regular dentist will work just fine in treating the TMJ and the guard typically should last as long as 5-10 years before needing to be replaced.

My sleeping pattern is awful even before using cpap, so I am very sensitive to whatever it may triggers migraine.

Lack of sleep can definitely trigger migraines in some people. So can sleeping too much at one time.

I didn't dream much before I started using cpap (only 2 and half moths now), it may be because my body alert me not going to REM to prevent sleep apnea. I found out I am dreaming more now after using cpap.

REM sleep is good.

I am easy to get headache so less strap on my head and face is better. Had tried the amara view full face mask, can't sleep at all, and it leaked like crazy since I had to keep it lose otherwise will get headache. Then tried the nuance gel nasal pillow, can't sleep either since too noise. Now I use the air fit p10 nasal pillow, at least can get me sleep a couple of hours, less headache. But the nasal tip is too hard sometimes it makes my nose very un-comfortable, and hard to sleep.

If the hard part of the P10 bothers you, you might want to try the slightly older Resmed Swift FX nasal mask. That has been my main mask ever since the start. I like the P10's headgear a bit better than the FX, but the hard platform that the pillows rest on in the P10 is no where near as comfortable as the totally soft FX. But the jet stream exhaust flow from the FX can also be problematic. It's nowhere near as nice as that totally diffused exhaust flow from the P10. Even with the jet stream exhaust flow, however, the FX is a fairly quite mask---if you have the exhaust vent aimed so that it does NOT hit the bedcovers or your pillow.

In fitting the Swift FX I find that I can wear the mask ridiculously loose and still get a good seal---even when I'm sleeping on my side and even when I have turned over onto my stomach.

I also have a full frame cover for my Swift FX that was designed by Pad-a-cheek since I don't like the feel of silicone against my skin. Pad-a-cheeks pillow cozies are available for many nasal pillow masks, including both the P10 and the FX. They can also make a difference in how the mask feels when you put it on.

You want support for posting shoddy research? You won't get it here.

Julie wrote:The headaches most of us get pre-Cpap are NOT migraines. They are pressure like, but short-lived, usually going away within a couple of hours after awakening. Of course some may have stronger and longer ones than others, but they are basically the result of low 02, high BP (which tends to come down once on Cpap) etc. Their origins may be similar to true migraines, but don't usually ever reach the level of pain or length of time and don't have auras.

I have to beg to differ here.

First, I don't think the origins of untreated OSA headaches and migraines are at all related. OSA headaches are caused by the repeated O2 desats. Migraines are caused by vascular and neurological problems within the brain itself.

Second, the pain from a migraine is seldom "pressure like". Migraines are far more likely to be described as "throbbing" or "stabbing". And most migraines occur distinctively on one side of the head. A really bad tension headache, on the other hand, can feel more like "pressure."

Third, it's also important to remember that most migraines are NOT accompanied by auras. And migraine pain can range from mild-moderate pain to excruciating pain. Episodic migraines with full blown aura are the classic migraine and most likely to involve the excruciating pain most people associate with the word "migraine." But oddly enough, if migraines become chronic (i.e. you start to have migraines almost every day), the actual pain level of an individual migraine typically goes down and the frequency of seeing auras often goes down. The problem with chronic migraines is that you are dealing with moderate pain almost every single day. And moderate migraines don't tend to respond well to OTC pain medication.

And using the terms 'headache' and 'migraine' interchangeably, randomly should not be done. They are not the same thing.

No-one I know with diagnosed migraines uses "migraine" and "headache" interchangeably. But most people with migraines also suffer from other types of headaches as well. When a migraineur uses the phrase "migraines or headaches" they are actually distinguishing between migraine headaches and headaches caused by other reasons.

Pressure like/throbbing are similar depending on who's talking - maybe I should have used another word for pressure. And the origins are not dissimilar as vascular problems in the brain are greatly affected by 02, or lack of it. And 40% of migraines are bilateral. And after working for neurologists for decades as I did you would not have said "No-one I know with diagnosed migraines uses "migraine" and "headache" interchangeably." It's not just drama queens/kings who talk about any headache as a migraine.

I respect your personal experience, but everyone's is different (I've never had migraines or headaches... tho' did have a.m. headaches for a couple of months pre-Cpap and mine felt pressure-like to me, but with a more 'demanding' component that might be described as throbbing, if not to the extent your migraines do.

Hi, Robysue,

Thanks so much for sharing the experience with me. I will certainly interesting in the CBT-I, that's my next step to try to resolve my sleep pb. Unfortunately, I have a very serious TMJ with open bite, I had both upper and lower jaws surgery before. So I am not able to wear any night guards. Less strap and absolutely the quietness are essential to me for the mask choice, otherwise, can't fall into sleep at all. Will keep the swift fx in mind for future consideration. It's interesting for the vitamin you brought up to help the sleep and migraine. I do believe there is some sort of hormone missing in my body. Will ask the doctor when I go to my appo. Thanks!

.

robysue wrote:I have to beg to differ here.

+1


Hi Jane... Welcome to the Forum. There is valuable information to be found here, but please read my signature.


.

Lucyhere wrote:.

robysue wrote:I have to beg to differ here.

+1


Hi Jane... Welcome to the Forum. There is valuable information to be found here, but please read my signature.


.

LOL, thanks Lucy. Advice noted.

Damn migraines. Mine come whenever they feel like it, I'm 55 and still can't pinpoint what causes them. Strobe/flashing lights sometimes. But also many times I'll get a headache from just relaxing, several days off or on a vacation. When I truly relax and not worry about this, that, these, and thoses many times I have gotten a migraine headache. Doesn't seem fair: relaxing leads to a headache that makes you feel like crap for a few days.

I have suffered for 70 years with migraines, mine are usually caused by eating something I am sensitive to, here are some links to my triggers.
this may help some that suffer

https://www.google.com/search?q=thyrami ... 8&oe=utf-8

https://www.google.com/search?q=does+so ... 8&oe=utf-8

https://www.google.com/search?q=MSG+cau ... 8&oe=utf-8

The things that I have to be aware of are red wine and M.S.G. (Monosodium glutamate) Until a few years ago MSG was found in Campbell soups and chinese food.A lot of foods said natural flavoring on their label. It was also MSG. There was a time if I ate in a restaurant and ended up with a migraine, it had to be MSG,

JaneAsimov wrote:

Julie wrote:The headaches most of us get pre-Cpap are NOT migraines. They are pressure like, but short-lived, usually going away within a couple of hours after awakening. Of course some may have stronger and longer ones than others, but they are basically the result of low 02, high BP (which tends to come down once on Cpap) etc. Their origins may be similar to true migraines, but don't usually ever reach the level of pain or length of time and don't have auras. Lack of sleep may trigger migraine protein problems, but that's a different story. And anecdotal evidence of anything is not usually considered in the same way as true research. And using the terms 'headache' and 'migraine' interchangeably, randomly should not be done. They are not the same thing.

Wow, who tied a knot in your hose?! I'm looking for some encouragement and support, not nitpicking. When I said "headaches/migraines" I meant that I get both, not that they're the same thing. Kind of weird that you're pointing that out anyway, who cares, many OSA suffers get both? I'm not going to waste my afternoon arguing about the evidence I posted either, since I referenced anecdotal evidence IN ADDITION to several scientific studies. Go find someone else to harass, you're not ruining my day

Hi Jane. welcome to the forum. Please don't pay any attention to Julie. She is an embarrassment to us all.

I found the articles you posted extremely interesting. I have suffered from several types of headaches all my life. When sleep-deprived, I will always have at least a nagging headache. CPAP has been a godsend for me. I always thought there was a connection between headaches and sleep problems. I am so glad to see some research done on the subject. I also had some other annoying issues like Nocturia, acid reflex, sore throats in the morning, and nasal congestion. CPAP therapy has greatly reduced or eliminated these.

I am happy to hear that you have become a CPAP user and are getting some headache relief.