Sleep and Headaches is a complex relationship including associations with RLS, OSA, Insomnia, and Hypnic Headaches (Poceta et al 2008).
“Because children with migraine headaches have a high prevalence of sleep disturbances, they should all be evaluated for the presence of sleep problems” (Isik et al 2006).
Polysomnogram Findings in Headaches include: Sleep disorder breathing, Short sleep time, Prolonged sleep latency, decreased REM, reduced slow wave sleep all can be seen in Migraine, And also Bruxism is associated with tension type headache (Vendrame et al 2008).
Hypercapnia can be associated with chronic headaches as retention of CO2 causes vasodilatation and diffuse headache. (Chest 2007 132:6)
More than 90% of school age children have had a headache. The prevalence of migraine increases with age. And there is gender differentiation as well, as the prevalence is greater in boys before 7 years of age, and is later greater in women than men.
Evaluation in younger children may be difficult, signs may be crying, rocking, or hiding.
Older children are better able to perceive and describe pain. Timing of the headaches needs to be considered.
Child Neurology Society guidelines for Neuroimaging of headaches include headaches that Acute (New Onset) or Chronic Progressive. Other symptoms that may indicate further Neurological evaluation include absence of family history of migraine, abnormal Neurological exam, changes in behavior or mental status, and sleep related headaches.
