Relationship between Apnea-Hypopnea Index and Oxygen Desaturation inREM-Sleep Period and Morning Headache in Patients with Obstructive SleepApnea Syndrome

AKÇAY, Bülent Devrim; Koc, Guray; karadaş, ömer; Yetkin, Sinan; Sayin, Refah; MEHEL METİN, KÜBRA

Relationship between Apnea-Hypopnea Index and Oxygen Desaturation inREM-Sleep Period and Morning Headache in Patients with Obstructive SleepApnea Syndrome

Güray KOÇ, (Gülhane Eğitim ve Araştırma Hastanesi, Nöroloji Anabilim Dalı, Ankara, Türkiye)

Kübra Mehel METİN, (Gülhane Eğitim ve Araştırma Hastanesi, Nöroloji Anabilim Dalı, Ankara, Türkiye)

Bülent AKÇAY, (Gülhane Eğitim ve Araştırma Hastanesi, Psikiyatri Anabilim Dalı, Ankara, Türkiye)

Ömer KARADAŞ, (Gülhane Eğitim ve Araştırma Hastanesi, Nöroloji Anabilim Dalı, Ankara, Türkiye)

Refah SAYIN, (Ufuk Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, Ankara, Türkiye)

Sinan YETKİN (Gülhane Eğitim ve Araştırma Hastanesi, Psikiyatri Anabilim Dalı, Ankara, Türkiye)

Nöropsikiyatri Arşivi

7 0

Yıl: 2020 Cilt: 57 Sayı: 4 Sayfa Aralığı: 294 - 298 Metin Dili: İngilizce İndeks Tarihi: 03-05-2021

Relationship between Apnea-Hypopnea Index and Oxygen Desaturation inREM-Sleep Period and Morning Headache in Patients with Obstructive SleepApnea Syndrome

Öz:

Introduction: In patients with morning headache, REM sleep period decreases though little is known about its physiopathology. We evaluate the polysomnographic records of obstructive sleep apnea syndrome (OSAS) patients with the hypothesis that oxygen desaturations may be a better determinant in patients with morning headache, especially those in REM sleep periods.Methods: Patient group (group 1) with a total of 361 patients with OSAS and the controls (group 2) with 107 healthy individuals were evaluated. The presence of morning headache was compared between the groups, and sleep parameters were correlated with morning headache.Results: In group 1, patients with OSAS and morning headache, apneahypopnea index in the REM sleep period (26.7/hour, min-max: 0–108.4/hour) was higher than those in patients without morning headache (17.8/hour, min-max: 0–107.8/hour). The minimum oxygen saturation in REM sleep period and total sleep time (TST) was lower in patients with morning headache (REM sleep period: 82%, min-max: 50–94% ; TST: 79%, min-max: 50–97%) in compared to patients without morning headache (REM sleep period: 84%, min-max: 50–93% ; TST: 81%, minmax: 50–90%).Conclusion: Here we demonstrated that higher apnea-hypopnea index and lower oxygen saturation in REM sleep period were associated with morning headache in patients with obstructive sleep apnea syndrome.

Anahtar Kelime:

Obstruktif Uyku Apne Sendromlu Hastalarda REM Uyku Dönemindeki Apne-Hipopne İndeksi ve Oksijen Desaturasyonu ile Sabah Baş Ağrısı Arasındaki İlişki

Öz:

Amaç: Sabah baş ağrısı olan hastalarda, REM uyku periyoduazalmıştır, ancak fizyopatolojisi hakkında az bilgi mevcuttur. Oksijendesatürasyonunun, özellikle REM uyku dönemlerinde olmak üzere,sabah baş ağrısı olan hastalarda daha belirgin olabileceği hipotezi ileobstruktif uyku apne sendromlu hastaların polisomnografik kayıtlarıincelendi. Yöntem: Toplam 365 hasta (Grup 1) ve kontrol grubu olarak 103birey (Grup 2) değerlendirildi. Gruplar arasında sabah baş ağrısı varlığıkarşılaştırıldı, sabah baş ağrısı olup olmamasına göre gruplar kendiiçlerinde ayrılarak uyku parametreleri açısından ayrıca karşılaştırıldı. Bulgular: Grup 1 içerisinde sabah baş ağrısı olan hastalarda REMdönemindeki apne-hipopne indeksi (26,7/saat, min-maks: 0–108,4/saat),sabah baş ağrısı olmayan gruba göre (17,8/saat, min-maks: 0–107,8/ saat) yüksek bulundu. REM dönemindeki ve toplam uyku zamanındakiminumum oksijen satürasyonu sabah baş ağrısı olan grupta (REM: %82,min-maks: %50–94; toplam: %79, min-maks: %50–97) sabah baş ağrısıolmayan gruba (REM: %84, min-maks: %50–93; toplam: %81, min-maks:%50–90) göre düşük bulundu. Sonuç: Bu çalışmada obstruktif uyku apne sendromlu hastalarda REMuyku dönemindeki yüksek apne hipopne indeksi ve düşük oksijensatürasyonunun sabah baş ağrısı ile ilişkili olduğu bulundu.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep 1999;22:667– 689.[CrossRef]
2. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993;328:1230–1235.[CrossRef]
3. Kripke DF, Ancoli-Israel S, Klauber MR, Wingard DL, Mason WJ, Mullaney DJ. Prevalence of sleep-disordered breathing in ages 40–64 years: a populationbased survey. Sleep 1997;20:65–76.[CrossRef]
4. Durán J, Esnaola S, Rubio R, Iztueta A. Obstructive sleep apnea-hypopnea and related clinical features in a population-based sample of subjects aged 30 to 70 yr. Am J Respir Crit Care Med 2001;163:685–689.[CrossRef]
5. Bixler EO, Vgontzas AN, Lin HM, Ten Have T, Rein J, Vela-Bueno A, Kales A. Prevalence of sleep-disordered breathing in women: effects of gender. Am J Respir Crit Care Med 2001;163:608–613.[CrossRef]
6. Paiva T, Farinha A, Martins A, Batista A, Guilleminault C. Chronic headaches and sleep disorders. Arch Intern Med 1997;157:1701–1705.
7. Biondi DM. Headaches and their relationship to sleep. Dent Clin North Am 2001;45:685–700.
8. Poceta JS. Sleep-related Headache. Curr Treat Options Neurol 2002;4:121– 128.[CrossRef]
9. Benbir Şenel G. Pathophysiology, signs and symptoms in snoring and obstructive sleep apnea syndrome. Turkiye Klinikleri Ear Nose and Throat - Special Topics 2018;3:1–8.
10. Headache Classification Subcommittee of the International Headache Society, The International Classification of Headache Disorders: 2nd edition. Cephalalgia 2004;1:9–160.
11. Ulfberg J, Carter N, Talbäck M, Edling C. Headache, snoring and sleep apnoea. J Neurol 1996;243:621–625.[CrossRef]
12. Ohayon MM. Prevalence and risk factors of morning headaches in the general population. Arch Intern Med 2004;164:97–102.[CrossRef]
13. Loh NK, Dinner DS, Foldvary N, Skobieranda F, Yew WW. Do patients with obstructive sleep apnea wake up with headaches? Arch Intern Med 1999;159:1765–1768.[CrossRef]
14. Paiva T, Batista A, Martins P, Martins A. The relationship between headaches and sleep disturbances. Headache 1995;35:590–596.[CrossRef]
15. Jennum P, Hein HO, Suadicani P, Gyntelberg F. Headache and cognitive dysfunctions in snorers. Arch Neurol 1994;51:937–942.[CrossRef]
16. Guilleminault C, Van den Hoed J, Mittler MM. Clinical overview of the sleep apnea syndromes. In: Guilleminault C, Dement WC, editors. Sleep Apnea Syndromes. New York, NY: Alan R Liss; 1978. pp.1–12.
17. Boutros NN. Headache in sleep apnea. Tex Med 1989;85:34–35.
18. Poceta JS, Dalessio DJ. Identification and treatment of sleep apnea in patients with chronic headache. Headache 1995;35:586–589.[CrossRef]
19. Neau JP, Paquereau J, Bailbe M, Meurice JC, Ingrand P, Gil R. Relationship between sleep apnea syndrome, snoring and headaches. Cephalagia 2002;22:333–339.[CrossRef]
20. Göder R, Friege L, Fritzer G, Strenge H, Aldenhoff JB, Hinze-Selch D. Morning headaches in patients with sleep disorders: a systematic polysomnographic study. Sleep Med 2003;4:385–391.[CrossRef]
21. Dodick DW, Eross EJ, Parish JM. Clinical, anatomical, and physiologic relationship between sleep and headache. Headache 2003;43:282–292. [CrossRef]
22. Goksan B, Gunduz A, Karadeniz D, Ağan K, Tascilar FN, Tan F, Purisa S, Kaynak H. Morning headache in sleep apnoea: clinical and polysomnographic evaluation and response to nasal continuous positive airway pressure. Cephalalgia 2009;29:635–641.[CrossRef]
23. Greenough GP, Nowell PD, Sateia MJ. Headache complaints in relation to nocturnal oxygen saturation among patients with sleep apnea syndrome. Sleep Med 2002;3:361–364.[CrossRef]
24. Iber C, Anconi-Israel S, Chesson AL Jr, Quan SF. The AASM manual for the scoring of sleep and associated events: rules, terminology, and technical specifications, 1st ed. Westchester, IL. American Academy of Sleep Medicine; 2007.
25. Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 1991;14:540–545.[CrossRef]
26. Singh NN, Sahota P. Sleep-related headache and its management. Curr Treat Options Neurol 2013;15:704–722.[CrossRef]
27. Olson LG, King MT, Hensley MJ, Saunders NA. A community study of snoring and sleep-disordered breathing. Symptoms. Am J Respir Crit Care Med 1995;152:707–710.[CrossRef]
28. Selekler HM, Sengun E, Altun N. Sleep Quality and Depression in Episodic and Chronic Migraine Sufferers. Arch Neuropsychiatry 2010;47:196–200.
29. Ozturk V, Oztura I, Ugurel B, Sahin O. How Frequently Is Obstructive Sleep Apnea Seen In Cluster Headaches? Neurol Sci Neurophysiol 2009;26:383– 389.
30. Özön AÖ, Karadaş Ö, Özge A. Efficacy of Diet Restriction on Migraines. Arch Neuropsychiatry 2018;55:233−237.[CrossRef]
31. Basoglu OK, Tasbakan MS. Gender differences in clinical and polysomnographic features of obstructive sleep apnea: a clinical study of 2827 patients. Sleep Breath 2018;22:241–249.[CrossRef]
32. Kristiansen HA, Kværner KJ, Akre H, Øverland B, Sandvik L, Russell MB. Sleep apnoea headache in the general population. Cephalalgia 2012;32:451–458. [CrossRef]
33. Alberti A, Mazzotta G, Gallinella E, Sarchielli P. Headache characteristics in obstructive sleep apnea syndrome and insomnia. Acta Neurol Scand 2005;111:309–316.[CrossRef]

APA	Koc G, MEHEL METİN K, AKÇAY B, karadaş ö, Sayin R, Yetkin S (2020). Relationship between Apnea-Hypopnea Index and Oxygen Desaturation inREM-Sleep Period and Morning Headache in Patients with Obstructive SleepApnea Syndrome. , 294 - 298.
Chicago	Koc Guray,MEHEL METİN KÜBRA,AKÇAY Bülent Devrim,karadaş ömer,Sayin Refah,Yetkin Sinan Relationship between Apnea-Hypopnea Index and Oxygen Desaturation inREM-Sleep Period and Morning Headache in Patients with Obstructive SleepApnea Syndrome. (2020): 294 - 298.
MLA	Koc Guray,MEHEL METİN KÜBRA,AKÇAY Bülent Devrim,karadaş ömer,Sayin Refah,Yetkin Sinan Relationship between Apnea-Hypopnea Index and Oxygen Desaturation inREM-Sleep Period and Morning Headache in Patients with Obstructive SleepApnea Syndrome. , 2020, ss.294 - 298.
AMA	Koc G,MEHEL METİN K,AKÇAY B,karadaş ö,Sayin R,Yetkin S Relationship between Apnea-Hypopnea Index and Oxygen Desaturation inREM-Sleep Period and Morning Headache in Patients with Obstructive SleepApnea Syndrome. . 2020; 294 - 298.
Vancouver	Koc G,MEHEL METİN K,AKÇAY B,karadaş ö,Sayin R,Yetkin S Relationship between Apnea-Hypopnea Index and Oxygen Desaturation inREM-Sleep Period and Morning Headache in Patients with Obstructive SleepApnea Syndrome. . 2020; 294 - 298.
IEEE	Koc G,MEHEL METİN K,AKÇAY B,karadaş ö,Sayin R,Yetkin S "Relationship between Apnea-Hypopnea Index and Oxygen Desaturation inREM-Sleep Period and Morning Headache in Patients with Obstructive SleepApnea Syndrome." , ss.294 - 298, 2020.
ISNAD	Koc, Guray vd. "Relationship between Apnea-Hypopnea Index and Oxygen Desaturation inREM-Sleep Period and Morning Headache in Patients with Obstructive SleepApnea Syndrome". (2020), 294-298.

APA	Koc G, MEHEL METİN K, AKÇAY B, karadaş ö, Sayin R, Yetkin S (2020). Relationship between Apnea-Hypopnea Index and Oxygen Desaturation inREM-Sleep Period and Morning Headache in Patients with Obstructive SleepApnea Syndrome. Nöropsikiyatri Arşivi, 57(4), 294 - 298.
Chicago	Koc Guray,MEHEL METİN KÜBRA,AKÇAY Bülent Devrim,karadaş ömer,Sayin Refah,Yetkin Sinan Relationship between Apnea-Hypopnea Index and Oxygen Desaturation inREM-Sleep Period and Morning Headache in Patients with Obstructive SleepApnea Syndrome. Nöropsikiyatri Arşivi 57, no.4 (2020): 294 - 298.
MLA	Koc Guray,MEHEL METİN KÜBRA,AKÇAY Bülent Devrim,karadaş ömer,Sayin Refah,Yetkin Sinan Relationship between Apnea-Hypopnea Index and Oxygen Desaturation inREM-Sleep Period and Morning Headache in Patients with Obstructive SleepApnea Syndrome. Nöropsikiyatri Arşivi, vol.57, no.4, 2020, ss.294 - 298.
AMA	Koc G,MEHEL METİN K,AKÇAY B,karadaş ö,Sayin R,Yetkin S Relationship between Apnea-Hypopnea Index and Oxygen Desaturation inREM-Sleep Period and Morning Headache in Patients with Obstructive SleepApnea Syndrome. Nöropsikiyatri Arşivi. 2020; 57(4): 294 - 298.
Vancouver	Koc G,MEHEL METİN K,AKÇAY B,karadaş ö,Sayin R,Yetkin S Relationship between Apnea-Hypopnea Index and Oxygen Desaturation inREM-Sleep Period and Morning Headache in Patients with Obstructive SleepApnea Syndrome. Nöropsikiyatri Arşivi. 2020; 57(4): 294 - 298.
IEEE	Koc G,MEHEL METİN K,AKÇAY B,karadaş ö,Sayin R,Yetkin S "Relationship between Apnea-Hypopnea Index and Oxygen Desaturation inREM-Sleep Period and Morning Headache in Patients with Obstructive SleepApnea Syndrome." Nöropsikiyatri Arşivi, 57, ss.294 - 298, 2020.
ISNAD	Koc, Guray vd. "Relationship between Apnea-Hypopnea Index and Oxygen Desaturation inREM-Sleep Period and Morning Headache in Patients with Obstructive SleepApnea Syndrome". Nöropsikiyatri Arşivi 57/4 (2020), 294-298.