**11. References**


H2O (Kristo 2009). CPAP ususally improves symptomatology and parasomnias. Some

No studies exist about the usefulness of positional treatment or electrical stimulation of the muscles of the upper airway in patients with UARS. With respect to drug treatment, as with OSAS, the evidence on the usefulness of pharmacological treatment in UARS is scarce. Given the poor adherence to CPAP treatment, oral devices may be a good alternative for UARS, although little research has been published (Loube 1998; Guerrero 2001; Yoshida 2002; Rose 2000). Predictable efficacy of oral appliances treatments has yet to be

Surgical option include laser-assisted uvulopalatoplasty,uvulectomy, snoreplasty injection, radiofrequency submucosal needle therapy and somnoplasty (Newman1996; Powell 1998; Newman 2002; Pirelli 2004). Existing data on treatment of UARS are scarce, which together

Despite the time elapsed since its initial description, UARS remains controversial as it has yet to be accepted as its own entity. However, the literature continues to reflect interest in this disorder. Perhaps SAHS and UARS share the same pathophysiological mechanism, although their clinical expression and pathophysiologic consequences are different. We could say that

SAHS is one of the most common sleep disorders in clinical practice. It is associated to cardiovascular morbidity, and has become regarded as a public health problem. UARS is an underdiagnosed disorder with low prevalence of sleep units. It has special implications on sleep structure, especially sleepiness and tiredness, and is associated to chronic somatic diseases such as chronic fatigue syndrome, fibromialgia, irritable bowel syndrome, and tension headache. The correct diagnosis of this syndrome is essential to allow the best choice

The identification of UARS, although not recognized by the AAMS as an entity, has improved our understanding of respiratory events and arousals, as well as increasing the search for non-invasively ways of assessing respiratory effort. Today, terms such as airflow

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**10. Conclusions** 

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**1. Introduction** 

breathing regulation.

has not been clearly evaluated.

 \*

C. Mariani1

**7** 

*Italy* 

C. Lovati et al\*

*L. Sacco Hospital, Milan,* 

**Breathing Sleep Disturbances and** 

Sleep and headache are two realities known to be linked in a bidirectional way [01]. Clinical research correlates specific headache diagnoses and sleep disorders with chronobiologic patterns and sleep processes, implicating that common anatomic structures and neurochemical processes are involved in the regulation of both sleep and headache. Sleep and pain perception share several structures, such as the thalamus, the hypothalamus, and a number of mesencephalic, pontine and bulbar nuclei, some of which are also involved in

The respiratory parameters during sleep at night may play a important role in modifying susceptibility to various pathological conditions, including headache. Morning headache was found to be more frequent among Obstructive Sleep Apnea Syndrome (OSAS) patients with a direct relationship with the severity of the sleep breathing disorder: apnoea hypopnoea index (AHI) has been found higher in OSAS patients with morning headache compared with those without morning headaches and also mean oxygen saturation value (SpO2) during total sleep time has been found significantly lower in OSAS patients with morning headache [02]. Furthermore, it has been observed that morning headache may be

The relevance of respiratory disturbances during sleep in subjects with primary headaches

Additionally, in a previous study we found that subjects with headache, and particularly those with headache-related cutaneous allodynia, had alterations in sleep behaviour [03]. Consequently, a possible link between sleep behavior disturbances, respiratory disorders

M. Zardoni1, D. D'Amico3, M. Pecis2, L. Giani1, E. Raimondi1, P. Bertora1, D. Legnani2, G. Bussone3,

largely resolved with nasal continuous positive airway pressure.

during sleep and primary headaches may be hypothesized.

*2Department of Pneumology , L. Sacco Hospital, Milan, Italy* 

*C. Besta Neurological Institute Foundation, Milan, Italy*

<sup>1</sup>*Department of Neurology and Headache Unit, L. Sacco Hospital, Milan, Italy* 

*3Headache Centre, Departement of Clinical Neurosciences and Headache Unit,* 

**Migraine: A Dangerous Synergy** 

**or a Favorable Antagonism?** 

*1Department of Neurology and Headache Unit,* 

