title: Tension-type headache associated with obstructive sleep apnea: a nationwide population-based study.
abstract: BACKGROUND
  There is still controversy regarding the association between primary headaches and obstructive sleep apnea. We explored the relationship between tension-type headache (TTH) and obstructive sleep apnea (OSA) using a large nationwide population-based data set in Taiwan.
  
  
  METHODS
  We identified 4759 patients diagnosed with OSA from the Taiwan Longitudinal Health Insurance Database, based on polysomnography, as the OSA group. We then randomly selected 19036 subjects without OSA, matched by sex and age, to serve as the non-OSA group. The multivariate Cox proportional hazards model with matching for age and sex was used to assess the possible associations between TTH and OSA among the patients.
  
  
  RESULTS
  The prevalence of TTH was 10.2% among OSA patients and 7.7% among non-OSA patients (p < 0.001). The multivariate Cox proportional hazards model revealed patients with OSA were more likely to have TTH (hazard ratio, 1.18; 95% CI, 1.06-1.31) (p = 0.003) than patients in the non-OSA group.
  
  
  CONCLUSIONS
  Patients with OSA had a higher likelihood of developing TTH than patients in the non-OSA group. Further studies of physiological patterns between OSA and TTH are needed to confirm the study findings.
authors.affiliation: Department of Otolaryngology, Taipei City Hospital, Taipei, Taiwan. yuioplk@hotmail.com.
authors.forename: Yu-Chwen
authors.initials: YC
authors.lastname: Chiu
authors.affiliation: Department of Education and Research, Taipei City Hospital, Taipei, Taiwan. A3547@tpech.gov.tw.|Department of Public Health, Institute of Public Health, National Yang Ming University, Taipei, Taiwan. A3547@tpech.gov.tw.
authors.forename: Hsiao-Yun
authors.initials: HY
authors.lastname: Hu
authors.affiliation: Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. fplee@tmu.edu.tw.|Department of Otolaryngology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. fplee@tmu.edu.tw.
authors.forename: Fei-Peng
authors.initials: FP
authors.lastname: Lee
authors.affiliation: Department of Otolaryngology, Taipei City Hospital, Taipei, Taiwan. hmengh@yahoo.com.tw.|Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. hmengh@yahoo.com.tw.
authors.forename: Hung-Meng
authors.initials: HM
authors.lastname: Huang
mesh_terms: D000328:Adult; D015897:Comorbidity; D005260:Female; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D015995:Prevalence; D012306:Risk; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology; D018781:Tension-Type Headache / Q000453:epidemiology*