ABSTRACT
The relationship between sleep and headache was recognized well over a century ago in medical texts and journals. Sleep apnea headache (SAH) is the only formal diagnosis of headache secondary to a sleep disorder, coded within “Headache attributed to hypoxia or hypercapnia,” although its mechanisms and criteria have not been validated. A comprehensive literature review concluded that it was unclear whether the mechanisms underlying SAH were hypoxemia or hypercapnia, or instead another non-respiratory consequence of sleep apnea. The parasomnia exploding head syndrome can present as sleep-related headache. Sleep triggers for migraine and tension-type headache were confirmed prospectively using time-series analysis. The convergence of sleep and headache disorders is generally believed to have its basis in neuroanatomical connections and neurophysiological mechanisms, particularly involving the hypothalamus, serotonin, and melatonin. Paper-and-pencil and electronic sleep diaries are probably the most commonly used systematic selfreport tools for sleep assessment.
