Tag: chronic daily headache

News & Research

Losing Sleep Connected to CDH & Migraine

Kerrie Smyres

Two-thirds of kids with CDH also have sleep disturbances, reported a study presented at last week’s Annual Conference on Sleep Disorders. Although the study is about kids, the findings seem to be applicable to adults.

Researchers were surprised by their findings. Kenneth Mack, one of the researchers, said: “The number of patients who have headaches and also sleep disturbance surprised us. They also have the same sleep disturbance: a delay in sleep onset.”

Even though people with CDH and migraine are probably not astonished by this news, it’s still significant. Until someone identifies something as a problem, it’s not considered a issue, particularly in medicine. Once a topic is studied and the results are meaningful, some doctors and nurses will start treating those symptoms. Of course, the research has to be replicated to establish the connection, but it still raises awareness of the issue.

It also encourages headache sufferers to consider whether their sleep is disturbed, which, again, is the first step in treatment. Since lack of sleep is a big headache trigger, treating it may reduce the frequency and intensity of one’s headaches.

Treatment

Promising Study for Acupuncture, Meds & CDH

Kerrie Smyres

The October issue of Headache reports results of a controlled trial of acupuncture for chronic daily headache. Researchers set out to see if people with CDH may benefit from treatment other than meds because “medical management” alone is often ineffective. The results indicate that, yes, CDH patients who combine acupuncture and meds suffer less than those who just take meds.

Unfortunately, the entire article is only available to registered Medscape users, but the abstract is viewable for everyone.

Methods
In a six-week period, the 74 participants either underwent 10 acupuncture sessions and had medical management by a neurologist or they only received medical management. Three neurologists from the same headache clinic, all of whom have “extensive experience” treating headache, provide the medical management.

There was no “sham” acupuncture, so participants and researchers both knew which group each patient was in.

Measurements and Tools
Health-related quality of life was examined using the Headache Inventory Test. Participants also told researchers the frequency and severity of their headaches in the month before the study. General health was assessed with a standardized health survey. Depression was checked using the Beck Depression Inventory.

Results
Participants who only had medical management did not show improvement. Compared to these patients, those who received medical management and acupuncture had and improvement of 3.0 points on the Headache Impact Test, as well as an increase of 8 or more points on the general health survey. Participants who received acupuncture were 3.7 times more likely to report less suffering from headaches at the end of the study.

Article authors do stress that participants with acupuncture report less suffering. They may actually have less pain, but they may also just perceive that they have less pain. Perception is reality. I doubt headache sufferers care if they actually have less pain or just think that they do. Either way they feel better.

Patient Education

Different Causes of CDH

Kerrie Smyres

I tend to use chronic daily headache and migraine interchangeably because my chronic migraines are thought to have transformed into daily headaches. I’m trying to stop doing this, though, because migraine is not the only instigator of CDH. In fact, the International Headache Society has identified 24 different causes for it.

American Family Physician published an article in December 2004 that describes the causes of chronic daily headache in the US and Europe. In 53% of cases, CDH begins from chronic tension-type headaches. Another 31% are chronic migraines that have transformed into daily headaches. In both type, the headaches gradually change from being distinct events to constant. Another common cause with a gradual onset is medication overuse, a.k.a. rebound headaches.

For the majority of those with CDH, one or more of the above classifications will fit. But for others, CDH may be brought on suddenly by head or neck trauma, flu-like illness, surgery, meningitis, or some other medical illness. I don’t know much about this second set of causes and I don’t really know how they are treated. But I expect that we experience very similar things with the different types of CDH.

News & Research, Treatment

Botox Study Details

Kerrie Smyres

Allergan has released details of its Phase II Botox study, the findings of which researchers presented at today’s AHS conference.

Based on these findings, the FDA has approved Allergan to progress to the Phase III study. This study, scheduled to begin late this year, will investigate how safe and effective Botox is for migraine patients with chronic daily headache.