REM Headache and CPAP treatment

I had a sleep study a couple yrs ago to find out if sleep apnea was causing my night time and early morning headaches. I was found to have mild to moderate sleep apnea and everyone thought cpap treatment would "cure" the headaches. No such luck! I'm still having headaches but the Sleepyhead software program has helped me pinpoint exactly when they are occuring - right after a period of increased respiraion when I distinctly remember dreaming or right after a period of REM sleep - so I am now calling them REM headaches. Has anyone else had this experience?? I see a neurologist who is trying to treat these headaches with a pharmacy of medications - so far unsuccessfully. The headaches are "better" in that I have a medication which will knock them out (indomethicin) but I still get the headaches EVERY NIGHT/MORNING. Here's the conundrum - I feel better/more rested on cpap so I guess I really do have sleep apnea, but the better I do on cpap (AHIs are now under 5), the better I sleep and the more dreaming I do which makes the headaches worse! Cpap is treating one problem and exacerbating another! Anyone else out there with this problem and what have you done about it? There is very little in the literature about REM headaches.

What does your data say about your events during the time you feel is REM? Do you have long events, or clusters? You might get some clarity by doing a night or more with a recording oximeter. Many people's events are worse during REM, and you need to know you machine is adequately treating them. If your data looks good, and your oxygen does not drop, it is probably going to take the help of a good neurologist to look for other causes for your symptoms. I for one would be interested in what you find out.

Thanks for the reply. I already considered oxygen might be the problem and had my sleep dr order an all night test - twice because the results were inconclusive. I tested it again myself by buying a recording pulsoximeter and this showed my O2 levels all night were fine. I still wasn't convinced so I somehow managed to get a month long trial of oxigen but it made no difference in the headaches. So now I finally believe they are not related. Just eyeballing the charts myself I don't see any clusters or increase in events during the periods of increased respiration. I can point right to spot on the SleepyHead charts where I get a headache because I wake up and showed it to my neurologist, but he said he never saw that before. So all we can do is keep trying different meds. I feel like a walking pharmacy! The official diagnosis, by the way, is Hypnic Headache but I call them REM headaches because that's when I get them.

birdwatcher wrote:Thanks for the reply. I already considered oxygen might be the problem and had my sleep dr order an all night test - twice because the results were inconclusive. I tested it again myself by buying a recording pulsoximeter and this showed my O2 levels all night were fine. I still wasn't convinced so I somehow managed to get a month long trial of oxigen but it made no difference in the headaches. So now I finally believe they are not related. Just eyeballing the charts myself I don't see any clusters or increase in events during the periods of increased respiration. I can point right to spot on the SleepyHead charts where I get a headache because I wake up and showed it to my neurologist, but he said he never saw that before. So all we can do is keep trying different meds. I feel like a walking pharmacy! The official diagnosis, by the way, is Hypnic Headache but I call them REM headaches because that's when I get them.

What kind of leak rates are you having? Is your therapy "optimized"?
Frankly, I find it "a stretch" to be able to look at Sleepyhead reports and be able to determine when REM stage sleep occurred. A person can dream in ANY sleep stage. Remembering them indicates they occurred in lighter stages (which is also what REM is).


Den

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I wish I could print my Sleepyhead charts and show you - but I never figured out how to do it. If you could see the Respiration chart you would see that once a night (rarely twice) I have a period of much higher repiration. I usually wake up right at the end of this period and have a headache. I also vividly remember the dream I was just having. Otherwise I'm doing really well on cpap. My AHIs are usually in the 2s and I never have any Large Leaks. My dodctor has made several adjustments to my pressure and I must have tried out 6 or 8 masks until I finally found one that didn't leak. I currently use a Resmed AirFit. The only leaks I get are when I turn over. So what's up with the headaches? I have no idea. I was hoping someone else might have experienced them.

Two things - to post pix here take some screen shots, attach them as new ones on Imgur.com (follow their directions) and then post the link in this thread.

The second is that I wonder if you've seen a neurologist - not all headaches are about OSA.

Thanks for telling me how to post SleepyHead charts. I'll try it! But for now I want to give you a quick answer on the neurologist - I've been seeing one for 3 yrs. The headaches have gotten a lot better on meds but I continue to look for that needle in the haystack that will lead to just the right treatment. It was my neurologist who referred me for the sleep study. We were all excited when I was diagnosed with sleep apnea as we thought that might explain and treat the headaches - but no luck so far! If anything the headaches seem worse when I sleep better on cpap and dream more!

I presume he's looked into cervical possibilities?

birdwatcher wrote:I wish I could print my Sleepyhead charts and show you - but I never figured out how to do it

three pages of handy instructions on how to organize sleepyhead for the most useful screenshots for posting here, how to take them, and then how to post on imgur:

https://sleep.tnet.com/resources/sleepyhead/shorganize