To the best of our knowledge, this study is the first to compare the sensitivity of the ICHD-3 beta criteria for “sleep apnoea headache “in OSAS patiens with morning headaches. In our study, we assessed headaches upon awakening in the morning but not headaches upon awakening during sleep or after a nap because the ICHD-3 beta criteria clearly state that a sleep apnoea headache is a morning headache caused by sleep apnoea.
This study demonstrated that 60.4 % and 81.3 % of patients with morning headache met the criteria for “sleep apnoea headache “established by ICHD-2 and ICHD-3 beta, respectively (Tables 1 and 2). The increased frequency of individuals who qualified for diagnosis was likely attributable to the extension of headache duration from 30 min to 4 h. This modification had clinical significance, as demonstrated in this study. Out of all morning headaches (n=48), 81.3 % (n=39) responded to CPAP therapy, and 19.7 % (n=10) of the CPAP treatable morning headaches did not fulfil the ICHD-2
criteria, although they all fulfilled the ICHD-3 beta criteria for " sleep apnoea headache ". Previous studies have demonstrated that 80-90 % of morning headaches improved after appropriate treatment (CPAP or uvulopalatopharyngoplasty) for OSAS (1, 13). Among habitual snorers, 32 % of all morning headaches less than 30 min.(6); in our study of OSAS patients, 31.3 % of all morning headaches lasted less than 30 min. In other studies, the proportions of morning headaches lasting less 1 h were 26.3 % (14) and 26.7 % (1) in OSAS patients. In our study, the proportion of morning headaches resolving within 4 h, that is, the duration specified by the ICHD-3 beta criteria, increased to 52.1 %.