Sleep disturbance management in patients with trigeminal autonomic cephalalgias

Trigeminal autonomic cephalalgias (TACs) are rare but are the most intense primary headaches that severely limit patients’ ability to work and be socially active. This article reviews the modern classification of TACs, based on the International Classification of Headache Disorders-3, and the key di...

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Main Authors: N. V. Vashchenko, A. M. Uzhakhov, Ju. E. Azimova
Format: Article
Language:Russian
Published: Remedium Group LLC 2021-12-01
Series:Медицинский совет
Subjects:
Online Access:https://www.med-sovet.pro/jour/article/view/6538
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author N. V. Vashchenko
A. M. Uzhakhov
Ju. E. Azimova
author_facet N. V. Vashchenko
A. M. Uzhakhov
Ju. E. Azimova
author_sort N. V. Vashchenko
collection DOAJ
description Trigeminal autonomic cephalalgias (TACs) are rare but are the most intense primary headaches that severely limit patients’ ability to work and be socially active. This article reviews the modern classification of TACs, based on the International Classification of Headache Disorders-3, and the key differences between TAC types, as well as the pathophysiological mechanisms – the role of the trigeminovascular system, autonomic nervous system, hypothalamus and vagus nerve – and their relation to circadian rhythms. The sleep disturbances that can occur in patients with TACs, exacerbating the course of the disease, and the role of melatonin, hypothalamus and suprachiasmatic nucleus in these conditions are also discussed. In addition, current therapies for cluster headache are described, which include acute therapy and prophylactic therapy, with recommendations regarding the timing of prophylactic therapy discontinuation. The review also includes the available data on melatonin as well as new therapies such as CGRP monoclonal antibodies and neuromodulation, which includes the two most promising techniques: non-invasive vagus nerve stimulation and sphenopalatine ganglion microstimulation. Furthermore, the authors present the clinical case of a patient with chronic cluster headache, which was significantly reduced in frequency and intensity when melatonin was added to the therapy.
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spelling doaj.art-cc23bef9aed749d18f210ebfd421286b2023-04-23T06:56:41ZrusRemedium Group LLCМедицинский совет2079-701X2658-57902021-12-0101910010810.21518/2079-701X-2021-19-100-1085901Sleep disturbance management in patients with trigeminal autonomic cephalalgiasN. V. Vashchenko0A. M. Uzhakhov1Ju. E. Azimova2Sechenov First Moscow State Medical University (Sechenov University); University Headache ClinicUniversity Headache Clinic; Institute of General Pathology and PathophysiologyUniversity Headache Clinic; Institute of General Pathology and PathophysiologyTrigeminal autonomic cephalalgias (TACs) are rare but are the most intense primary headaches that severely limit patients’ ability to work and be socially active. This article reviews the modern classification of TACs, based on the International Classification of Headache Disorders-3, and the key differences between TAC types, as well as the pathophysiological mechanisms – the role of the trigeminovascular system, autonomic nervous system, hypothalamus and vagus nerve – and their relation to circadian rhythms. The sleep disturbances that can occur in patients with TACs, exacerbating the course of the disease, and the role of melatonin, hypothalamus and suprachiasmatic nucleus in these conditions are also discussed. In addition, current therapies for cluster headache are described, which include acute therapy and prophylactic therapy, with recommendations regarding the timing of prophylactic therapy discontinuation. The review also includes the available data on melatonin as well as new therapies such as CGRP monoclonal antibodies and neuromodulation, which includes the two most promising techniques: non-invasive vagus nerve stimulation and sphenopalatine ganglion microstimulation. Furthermore, the authors present the clinical case of a patient with chronic cluster headache, which was significantly reduced in frequency and intensity when melatonin was added to the therapy.https://www.med-sovet.pro/jour/article/view/6538trigeminal autonomic cephalgiacluster headachesleep disordersmelatoninpreventive therapy
spellingShingle N. V. Vashchenko
A. M. Uzhakhov
Ju. E. Azimova
Sleep disturbance management in patients with trigeminal autonomic cephalalgias
Медицинский совет
trigeminal autonomic cephalgia
cluster headache
sleep disorders
melatonin
preventive therapy
title Sleep disturbance management in patients with trigeminal autonomic cephalalgias
title_full Sleep disturbance management in patients with trigeminal autonomic cephalalgias
title_fullStr Sleep disturbance management in patients with trigeminal autonomic cephalalgias
title_full_unstemmed Sleep disturbance management in patients with trigeminal autonomic cephalalgias
title_short Sleep disturbance management in patients with trigeminal autonomic cephalalgias
title_sort sleep disturbance management in patients with trigeminal autonomic cephalalgias
topic trigeminal autonomic cephalgia
cluster headache
sleep disorders
melatonin
preventive therapy
url https://www.med-sovet.pro/jour/article/view/6538
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