Neurology Advisor spoke with 2 experts in sleep and headache about the clinical implications of these comorbid disorders.
Neurology Advisor: The combination of sleep deprivation or inadequate sleep quality and headache pain can trigger a chronic cycle. Can you break the cycle merely by improving sleep? What types of interventions do you recommend?
Dr Pavlovic: One approach to this cycle of (often) daily headaches is to stabilize sleep in the hope that removing the presumed headache trigger will stabilize headaches. Another is to treat headache with a preventive therapy with the hope that stabilization of the headache will help improve sleep dysfunction as well. A third approach, and one commonly employed in clinical practice, is to use a modality—such as tricyclic antidepressants—that has an effect on sleep and headache in order to improve both simultaneously.
Supporting the mandible more forward decreases many sleep disorders, and decreases headaches. No drugs are required to achieve these improvements. Since no drugs are used, there are no drug side effects.