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Morning Headache a Widespread Problem

Those with depression, anxiety disorders at higher risk

MONDAY, Jan. 12, 2004 (HealthDayNews) -- A morning headache is a common experience for one of every 13 persons, a new survey finds, and these painful awakenings are closely associated with depression and anxiety.

The survey included 18,980 residents of five European countries, and the incidence of morning headaches is almost certainly similar in the United States, says Dr. Maurice M. Ohayon, an associate professor of psychiatry and behavioral sciences at Stanford University School of Medicine.

He reports his results in the Jan. 12 issue of The Archives of Internal Medicine.

The high incidence of morning headache "is very surprising," Ohayon says. "It means that a lot of people are suffering."

"With a population of 300 million in America, it means that 27 million people are suffering," he says. These are people who do not sleep well, who wake up with pain. There are probably a lot of consequences, in their work and their personal relationships."

Heavy drinkers, people with high blood pressure and those with conditions affecting muscle and skeletal function are among those most likely to start the day with a throbbing head, the survey finds. But the highest incidence was among people with depression and anxiety disorders.

In all, 1,442 people, 7.6 percent of those who were questioned, said they have chronic morning headaches -- 1.3 percent every day, 4.4 percent "often" and 1.9 percent "sometimes."

Women are slightly more likely to have chronic morning headaches (8.4 percent vs. 6.7 percent of men) and one of every 11 middle-aged persons, aged 45 to 65, is a persistent sufferer.

The survey produces one "do" and one "don't" for people with chronic morning headaches, says Dr. Seymour Diamond, executive chairman of the National Headache Foundation and director of the Diamond Headache Center in Chicago.

"If you wake up with a headache every morning, you should check your blood pressure," Diamond says, because of the link between high blood pressure and morning headaches found in the survey.

But don't think surgery to correct a breathing disorder will do much for the headache problem, Diamond says.

"There is a lot of literature about morning headaches are due to obstructive nose disease and other types of obstructed breathing," he says. "This survey does not validate that opinion."

Mainly, Diamond adds, "this survey solidifies the fact that depressive disorders can cause frequent early morning headaches."

The best medications for chronic headache sufferers are the older tricyclic antidepressants such as amitryptyline (Elavil) and amoxapine (Asendin), Diamond says. They are available in less expensive generic versions and have been "more effective in my clinical practice" in preventing headaches than newer SSRI antidepressants such as fluoxetine (Prozac), he says.

More information

A summary of the morning headache problem is offered by the National Headache Foundation. Here's more on depression.

SOURCES: Maurice M. Ohayon, M.D., Ph.D, associate professor, psychiatry and behavioral sciences, Stanford University School of Medicine, Palo Alto, Calif.; Seymour Diamond, M.D., director, Diamond Headache Center, Chicago; Jan. 12, 2004, Archives of Internal Medicine
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