Friday, June 20, 2008

What You Must Know About Sinus Headaches

Many of my patients come to see me for their severe sinus headaches with pain, pressure, sinus congestion and pure misery. Most are surprised, if not shocked, when I tell them that their sinus headache is really a variation of a migraine attack in their sinuses. Some don't believe me at all. Many of these same patients can also have mild nausea, light or sound sensitivity. Some have none of these other symptoms. The true test lies in their response to an anti-migraine medication, whether an OTC or prescription medication. Some of my patients respond very well to Excedrin Migraine, a common OTC medication. Others respond to prescription medications for migraine, such as Imitrex.

A recent paper presented at the 111th meeting of the Triological Society's Combined Otolaryngology Spring Meeting, showed that a class of migraine aborting medications (tryptans) brought relief to more than 80% of sinus headache sufferers. They gave these people with normal CAT scans a 40 mg dose of eletriptan and another dose two hours later if not improved. Overall, 31 out of 38 patients achieved 50% or greater relief of symptoms, and another 8 went on to respond to a different type of tryptan medication (82% response total).

The study's findings mirror what I've been seeing in my practice for the past few years. What the presenters don't explain, however, is why these sinus headaches (migrianes) are happening. Again this is another example of covering up a symptom, without getting to the root cause of the problem. What I've found is that almost every one of these patients have problems sustaining deep sleep due to poor breathing at night. By helping them breathe and sleep better, helping them adjust their eating habits and timing, and by calming and relaxing the stress responses that builds up, patients overall feel much better.

Do you suffer from sinus or migraine headaches? If so, how much does it affect your life?

Wednesday, June 11, 2008

SLEEP Meeting 2008 Summary

I spent all day yesterday at the SLEEP 2008 national meeting in Baltimore. I  went to qualify various home testing options (I have three to choose from), but I wanted to mention in this blog a few interesting companies and products that I  saw.

Cure for Insomnia?
For people with severe insomnia, I've mentioned cognitive behavioral therapy or CBT. It's been found work better than sleeping pills, and many people can stop taking these pills as well. The problem has been that it's very labor and time intensive. I was pleasantly
surprised to see an online version of CBT, developed by a Harvard insomnia researcher. Check it out here.

Elephant CPAP Mask
I was walking by a booth and I did a double take, as I thought I saw an elephant's nose. I turned around and saw this device in the picture below. It's made of a soft fabric and it allows you to sleep on your side with no rigid tubing or plastic mask to get in the way. You can find out more information or order it here
Football Helmet for Sleep Apnea?
Many people hate CPAP because they can't sleep on their stomach, face down. The mask and the tubing comes off when this is attempted. A device that I saw looks almost like a football helmet but on closer inspection is a light plastic helmet with  thick rounded bars (like a face mask) in front of the face to accommodate for the CPAP mask and tubing. It's patent is pending and may take another 1-2 years to become available. You can see the design at

After many hours of walking, my tired feet took me to a company called "Happy Feet." Not the penguin movie, but a shoe insert that's filled with glycerin that massages your feet when walking. I bought a pair and so far so good. You can check them out here.