Many different kinds of sleep disorders related to headache One such sleep is characterized by a disturbance in the 24-hour rhythm. Until recently it was difficult to treat sleep problems.
The past five years, new opportunities developed to patients with a 24-hour help arrhythmias (2). Based on two case histories of migraine patients with a 24-hour rhythm disorder will discuss these new developments.
Health Histories
* Patient 1 was a 47 years old male engineer who had migraine with aura since childhood.
Because of these attacks, he could at least 1 days work per week. The patient took 9 different analgesics (paracetamol, aspirin and NSAIDs) per week, and 10 tablets of sumatriptan (Imigran) per week. During the day he was very tired. His mood was depressed. He smoked 20 cigarettes a day and drank a bottle of wine per day.
Apart from this, his medical history was normal.
During migraine attacks the patient slept prefer. When asked “Do you sleep badly”, he said: “On the contrary, I sleep very well. I even need 3 alarms to wake up, at my time at work can be.”
On weekends however, he slept at noon. Then he was often less tired and he felt better than on weekdays when he was asked to. He said he needed the weekend to its battery for the next week to recharge. Much to his annoyance, his battery is often empty again before the start of the next weekend. That is why he is often sick.
The patient was 12 hours at night to bed and fell asleep for about 2 hours.
He considered himself a pronounced avondman. The neurological and biochemical screening were normal for him. We took the patient home hypnogrammen (curves of the sleep pattern) with a portable cassette recorder EEC, both during a night during the week as a night on weekends. Both hypnogrammen showed a normal sleep structure seen from the moment the patient fell asleep. During the week however, the patient slept only 4 hours. In contrast, the weekend about 9 hours. This hypnogrammen suggested that the sleep stage was delayed a few hours: while the normal sleep phase of 12 hours to 7 hours, was the delayed sleep phase of the patient for 2 to 11 hours. This type of sleep disorder called Delayed Sleep Phase Syndrome (Delayed Sleep Phase Syndrome (DSPS). This disorder is the biological clock in an unusual set time (8). The case history of the patient reminded migraine with aura, related to abuse of addictive substances.
We proposed the theory that short sleep time, relating to the 24-hour rhythm disturbance, fatigue and a depressed mood caused.
The increase of the headache and the increase of daily functioning poor, not by the patient and his doctors were included, perhaps to put the patient to seek his help in alcohol. We decided the 24-hour treat arrhythmia, in the hope that the migraines would decrease. First we tried the lifestyle of the patient to match his biological clock. The patient was explained the influence of sleep on daily functioning. Then we asked the company doctor of the patient to the working hours of the patient to his biological clock to adjust.
The patient was allowed to work 1 hours afternoon to begin and when he wished he could a few hours after dinner to work. Simultaneously, he was encouraged to leave medicine. Three months later the number of migraine attacks decreased to about one attack per Mon Besides the patient reported no sick days to feel.
About 4 months later, the number of attacks but gradually to 4 attacks per Mon The illness grew to 3 days per Mon The patient stated that absenteeism and increase in attacks by saying that morning he could not be missed at work. Any significant consulting work was the morning instead. This working meeting heard to attend to fulfill their functions. The patient thought he had to choose between either look for another job (which he probably could not find) or adjust its biological clock to the demands of his work.
Because he strongly preferred the latter option, we decided to start treatment with melatonin.
The patient was given 5 mg melatonin, taken at 22.00 pm. From that time he was able to sleep much earlier. He went to sleep 12 hours and fell asleep at half past twelve. He woke at half past seven. He used only one alarm. In the weekend he was awake at half past nine. His migraine attacks also took down to 1 attack per Mon Perhaps because his future is looking much brighter, even improved his record to a certain elation.
Tags: disorders related to headache, doctor, Headache, Health Histories, migraine attacks, related to headache, sleep disorders related
First one should try doing other techniques to induce sleep. But medications can actually improve the quality of sleep.