Is There a Relation between Tension-Type Headache, Temporomandibular Disorders and Sleep?

Introduction. Tension-Type Headache (TTH) is the most prevalent headache often associated with impaired function and quality of life. Temporomandibular Disorders (TMD) and TTH frequently coexist; characterized by pericranial tenderness and impact on daily life. We aim to apply a standardized questionnaire for TMD to characterize and analyse an eventual relation between sleep and oral health in TTH in a controlled design. Material and Methods. 58 consecutive TTH patients and 58 healthy controls were included. The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) questionnaire, Oral Health Impact profile (OHIP) and questionnaires for sleep were applied. Results. TTH-patients had significantly higher pain scores (P < 0.001), decreased quality of life (P < 0.001), and higher total sleep scores (P < 0.001) compared to controls. Conclusion. For the first time we have identified a clear relation between TTH and TMD symptoms, depression, anxiety, poor sleep, and impairments of oral function in carefully classified patients. These findings indicate a close, but incomplete, overlap between TTH and TMD. Their underlying pathophysiological mechanisms need further research.

High mass resolution time of flight mass spectrometer for measuring products in heterogeneous catalysis in highly sensitive microreactors

We demonstrate a combined microreactor and time of flight system for testing and characterization of heterogeneous catalysts with high resolution mass spectrometry and high sensitivity. Catalyst testing is performed in silicon-based microreactors which have high sensitivity and fast thermal response. Gas analysis is performed with a time of flight mass spectrometer with a modified nude Bayard-Alpert ionization gauge as gas ionization source. The mass resolution of the time of flight mass spectrometer using the ion gauge as ionization source is estimated to m/Δm > 2500. The system design is superior to conventional batch and flow reactors with accompanying product detection by quadrupole mass spectrometry or gas chromatography not only due to the high sensitivity, fast temperature response, high mass resolution, and fast acquisition time of mass spectra but it also allows wide mass range (0-5000 amu in the current configuration). As a demonstration of the system performance we present data from ammonia oxidation on a Pt thin film showing resolved spectra of OH and NH(3).

Craniofacial Pain and Jaw-muscle Activity during Sleep

This study compared the jaw-muscle electromyographic (EMG) activity during sleep in patients with craniofacial pain (n = 63) or no painful conditions (n = 52) and between patients with tension-type headache (TTH: n = 30) and healthy control individuals (n = 30). All participants used a portable single-channel EMG device (Medotech A/S) for four nights. There was no significant difference in EMG activity between craniofacial pain (24.5 ± 17.9 events/hr) and no painful conditions (19.7 ± 14.5), or between TTH (20.8 ± 15.0) and healthy control individuals (15.2 ± 11.6, p >.050). There were positive correlations between EMG activity and number of painful muscles (r = 0.188; p = 0.044), characteristic pain intensity (r = 0.187; p = 0.046), McGill Pain Questionnaire (r = 0.251; p = 0.008), and depression scores (r = 0.291; p = 0.002). Patients with painful conditions had significantly higher night-to-night variability compared with pain-free individuals (p < 0.050). This short-term observational study suggests that there are no major differences between patients with different craniofacial pain conditions and pain-free individuals in terms of jaw-muscle EMG activity recorded with a single-channel EMG device during sleep. However, some associations may exist between the level of EMG activity and various parameters of craniofacial pain. Longitudinal studies are warranted to further explore the relationship between sleep bruxism and craniofacial pain.

Treatment of medication overuse headache--guideline of the EFNS headache panel

BACKGROUND

  Medication overuse headache is a common condition with a population-based prevalence of more than 1-2%. Treatment is based on education, withdrawal treatment (detoxification), and prophylactic treatment. It also includes management of withdrawal headache.

AIMS

  This guideline aims to give treatment recommendations for this headache.

MATERIALS AND METHODS

  Evaluation of the scientific literature.

RESULTS

  Abrupt withdrawal or tapering down of overused medication is recommended, the type of withdrawal therapy is probably not relevant for the outcome of the patient. However, inpatient withdrawal therapy is recommended for patients overusing opioids, benzodiazepine, or barbiturates. It is further recommended to start individualized prophylactic drug treatment at the first day of withdrawal therapy or even before. The only drug with moderate evidence for the prophylactic treatment in patients with chronic migraine and medication overuse is topiramate up to 200mg. Corticosteroids (at least 60mg prednisone or prednisolone) and amitriptyline (up to 50mg) are possibly effective in the treatment of withdrawal symptoms. Patients after withdrawal therapy should be followed up regularly to prevent relapse of medication overuse.

DISCUSSION AND CONCLUSION

  Medication overuse headache can be treated according to evidence-based recommendations.

Cluster headache and sleep, is there a connection? A review

PURPOSE OF REVIEW

Sleep and the chronobiological disease cluster headache are believed to be interconnected. Despite efforts, the precise nature of the relationship remains obscured. A better understanding of this relation may lead to more effective therapeutic regimes for patients suffering from this debilitating disease. This review aims to evaluate the existing literature on the subject of cluster headache and sleep.

LATEST FINDINGS

Several previous studies describe an association between episodic cluster headache and distinct macrostructural sleep phases. This association was not confirmed in a recent study of seven episodic cluster headache patients, but it was suggested that further studies into the correlation between cluster headache attacks and the microstructure of sleep are relevant. The connection between cluster headache and the hypocretins is currently under investigation.

SUMMARY

There is evidence in favour of an association between episodic cluster headache and REM sleep whereas no such relation to chronic cluster headache has been reported. Particular features in the microstructure of sleep and arousal mechanisms could play a role in the pathogenesis of cluster headache. Reports indicate that cluster headache and obstructive sleep apnoea are associated. Single cases show improvement upon treatment of sleep apnoea, but the causal relationship remains in question.

Signals of change in tropical savanna woodland vertebrate fauna 5 years after cessation of livestock grazing

Context There is growing evidence that vertebrates inhabiting the extensive savannas of northern Australia are undergoing a widespread decline as a result of the effects of anthropogenic land management such as the grazing of domestic stock. Despite the ubiquity of pastoral grazing in the Australian savannas, few studies have examined the changes in terrestrial vertebrate fauna following destocking. Aims The present study monitored the response of birds, mammals and reptiles to destocking of a newly acquired conservation reserve in north-eastern Australia. Methods The vertebrate fauna was sampled over a 5-year period. Standardised 1-ha survey was conducted twice a year in 2006, 2007 and 2010, at 40 sites representing six habitat types. Key results The fauna assemblage, the abundance and richness of major taxa, and the abundance of a suite of individual species were found to vary significantly with time since destocking. Although some of the observed trends were consistent with previously reported responses of vertebrates to grazing, in general species richness and abundance did not increase linearly over time since destocking, with an overall decline in the first year, and an increase in the subsequent survey. Mammals remained at very low abundance and displayed a trend contrary to that for birds and reptiles, and variation was often confounded by habitat type. Conclusions In general, where there has been a long history of pastoral land management, destocking alone may not induce short-term increases in the vertebrate fauna thought to be affected by grazing in Australian savannas. Implications Monitoring the outcomes of conservation management activity is a critical component of understanding the success, failures and adaptation needed to maximise the costs and benefits of conservation investment. The recovery of the vertebrate fauna thought to be of conservation concern in relatively intensively used, long-grazed landscapes may be lengthy and contingent on other factors, such as periods of favourable weather, or understanding the interactive effects of herbivore removal, fire pattern and feral predators. In such landscapes, it is possible that recovery of some elements of the vertebrate fauna may not occur without deliberate interventions, such as reintroductions or intense predator control.