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?