title: Sleep apnoea headache in obstructive sleep apnoea syndrome patients presenting with morning headache: comparison of the ICHD-2 and ICHD-3 beta criteria.
abstract: BACKGROUND
  Morning headache is associated with obstructive sleep apnoea syndrome (OSAS); however, OSAS patients present with various characteristics of morning headache, and they often do not fulfil the International Classification of Headache Disorders (ICHD)-2 criteria for "sleep apnoea headache". The aims of this study were to assess the new ICHD-3 beta criteria for sleep apnoea headache in OSAS patients and to evaluate the differences with the ICHD-2.
  
  
  METHODS
  We conducted a cross-sectional survey regarding morning and sleep apnoea headaches that included 235 OSAS outpatients receiving continuous positive airway pressure (CPAP) treatment. The presence of morning headache was evaluated by reviewing the medical records before administration of CPAP treatment.
  
  
  RESULTS
  Of all of the OSAS patients, 48 (20.4%) reported morning headaches. Of the 48 patients with morning headaches, 29 (60.4%) and 39 (81.3%) fulfilled the ICHD-2 and ICHD-3 beta criteria for sleep apnoea headache, respectively. The increased frequency of individuals who qualified for diagnosis was likely attributable to the extension of headache duration from 30 min to 4 h. The severity of OSAS was not associated with the presence of sleep apnoea headache.
  
  
  CONCLUSIONS
  The utilisation of ICHD-3 beta criteria is clinically useful for diagnosing sleep apnoea headache in patients with OSAS. Applying the ICHD-3 beta criteria was of clinical significance when considering the marked response of these headaches to CPAP therapy. The cause of sleep apnoea headache remains to be elucidated.
authors.affiliation: Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, 321-0293, Japan, keisuke@dokkyomed.ac.jp.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Suzuki
authors.forename: Masayuki
authors.initials: M
authors.lastname: Miyamoto
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Miyamoto
authors.forename: Ayaka
authors.initials: A
authors.lastname: Numao
authors.forename: Shiho
authors.initials: S
authors.lastname: Suzuki
authors.forename: Hideki
authors.initials: H
authors.lastname: Sakuta
authors.forename: Akio
authors.initials: A
authors.lastname: Iwasaki
authors.forename: Yuji
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Fujita
authors.forename: Koichi
authors.initials: K
authors.lastname: Hirata
mesh_terms: D000328:Adult; D000368:Aged; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D003430:Cross-Sectional Studies; D005260:Female; D020773:Headache Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D013997:Time Factors