January 18, 2012 | 
Author We have an inner biological pacemaker, known as the circadian clock. Circadian comes from the Latin circa (“about”) and diem (“a day”). This timekeeper, based on the daily cycles of light and dark influence many of our physiological rhythms and activities. SCN or suprachiasmatic nucleus is a tiny clock buried deep in the brain which paces body temperature, blood pressure heart rate, hormone levels, and sleep-waking times. It tells your brain’s pineal gland when to release melatonin to promote sleep, and when it should stop to help you awaken. As we talked about recently, SAD (seasonal affective disorder) which sprouts up in the winter for some people due to lower light levels is associated with our own personal circadian clock.
Distinguishing ourselves as “morning” or “night” people is something most of us do. Another name for a morning person is a lark. Larks typically wake up easily in the morning, feeling refreshed. Owls on the other hand struggle to get out of bed in the morning, and may prefer staying up late into the night. We all know who we are! Circadian research is a growing area of research, not only for charting why we are wired differently in terms of our sleep patterns, but also how time of day can affect chemotherapy, surgery and other treatments…..The Scientific American Day in the Life of your Brain by Judith Horstman
A study recently published in the journal Biological Psychiatry found that stressful life events can lead to shrinkage of the brain due to reductions in gray matter in regions connected to physiological and emotional functions. The study used brain imaging on 103 people who had previously experience traumatic or stressful life events such as divorce, death of a loved one, or natural disasters and found that these individuals had lower than average amounts of gray matter in parts of the medial prefrontal cortex, the brain region responsible for self control, emotion regulation, blood pressure, and glucose levels. Study researcher Emily Ansell, assistant professor of psychiatry at Yale University found that “the accumulation of stressful life events may make it more challenging for these individuals to deal with future stress, particularly if the next demanding event requires effortful control, emotion regulation, or integrated social processing to overcome it,” and warned that changes in gray matter in the brain could contribute to future psychiatric problems.
Dr. Sonia Lasaosa, MD, et al. studied the supposed link between the lack of a nocturnal decrease in blood pressure, which is seen in individuals with obstructive sleep apnea, and the occurrence of cluster headaches. For the study, 30 patients with episodic cluster headaches were given blood pressure cuffs to monitor their ambulatory blood pressure. These readings were then used to determine the average blood pressure during sleep, average blood pressure during wakefulness, and the decrease in blood pressure during sleep. During normal sleep there is a 10% – 20% “nocturnal dip” in blood pressure, while a dip of less than 10% is considered abnormal. Of the 30 participants in the study, 15 experienced the abnormal lack of dipping, a frequency which was higher than expected. Previous studies have shown that a reduction in mean oxygen saturation due to changes in circadian blood pressure rhythm may be the triggering factors which lead to cluster headaches. The high incidence of the abnormal lack of dipping in patients with episodic cluster headaches supports the hypothesis of a possible relationship between obstructive sleep apnea and cluster headaches. Ambulatory blood pressure monitoring has also proved to be an effective technique which could alert neurologists to the potential risk of cardiovascular disease and the need to check for sleep apnea syndrome in patients with cluster headaches.
For further reading: Social Vocalizations can Release Oxytocin in Humans
The holidays are a time of celebrations and family gatherings. From Thanksgiving to New Year’s, we often spread ourselves too thin-we get too little sleep, eat and drink too much, and have high expectations for ourselves. But once the holidays are over, it can be a time of emptiness and depression. About 25% of people have feelings of lonliness and letdown in January. People have more illnesses in January which can be attributed to the “letdown effect.” This is characterized as “a condition where high energy or activation levels in the body are immediately followed by a rapid drop in activation levels.”
According to B. Greenberg, author of Wrung Out By Ringing In The Holidays, it’s important to know “there’s no reason to feel badly that you feel badly, and no reason to force your feelings to be different than what they are.”
Try to stay active and engaged with people you enjoy. Talking about your feelings of letdown with friends may help, and you may find they share similar feelings. As always, seek help from a professional if depression lingers.
A study published in the journal Pediatrics found that girls are more likely than boys to have headaches after suffering a traumatic brain injury, such as a concussion. Approximately 1.7 million people suffer a traumatic brain injury each year according to the U.S. Centers for Disease Control. Roughly 75 percent of these injuries are concussions, which are considered one of the milder traumatic injuries.
The study looked at the prevalence of headaches in children aged 5 to 17. Three months after a mild injury 43 percent of children reported headache, while 37 percent of children with moderate to severe injuries said they had headaches. Of those children with mild brain injuries who reported headaches, 59 percent were girls.
Michael Collins PhD., is director of the concussion program at the University of Pittsburgh Medical Center’s Sports Medicine clinic. “Concussion and migraines are evil cousins,” according to Collins. People who are susceptible to migraines can suffer concussions from head traumas too mild to impact whose who are not prone to migraines, and the concussions they suffer are usually more severe. ”The evil genie comes out of the bottle, ” Collins said. Additionally, girls are four to six times more likely to suffer from migraines, which could account for why girls are likelier to have headaches after a mild brain injury, though other factors could be involved……..Pittsburgh Post-Gazette Jacky Kelly
Seasonal affective disorder, or SAD affects many people during the winter months. Its especially prevalent in northern parts of the world from November through March where light levels are lower. Less sunlight can confuse our internal body clock…making us feel sluggish and depressed. Some people have described the feeling of being in constant jet lag.
For many people who suffer from SAD medication and counseling can help. Light therapy can also be an extremely effective treatment for seasonal affective disorder. A specially made light box can be used at home on a daily basis during the winter months. Sitting 18 inches away for about half an hour a day can make a big difference for people struggling with light deprivation. Equally impressive is that there are no side effects to using one.
The SunBox company in Gaithersburg, Maryland makes a quality light box… and no prescription needed.
Refractory means “difficult to treat”…where the headaches have not responded to the usual minstrations..this is a common situation. Previously, I had published several studies(in our Archives) on long-term effects of daily headache preventives: bottom line is, only about 46% of headache patients have “long-term” success from the preventives(such as antidepressants/beta blockers/anticonvulsants, etc.). From months 6 to 15, after starting preventives, many people stop them because of declining efficacy and/or side effects.
So, what happens to these(3 million in the US) people with chronic daily headaches and no effective treatment?….I started the section of the American Headache Society 11 years ago on The Refractory Headache Patient. I have published on this(see articles on our homepage)….some of the medication approaches I employ include: long-acting opioids, frequent triptans, stimulants, MAOI’s, and Botox. However, for some nothing really works: we desperately need better and newer headache(and pain) preventives.
Posted in headachedrugs | 
Tags: botox, chronic migraine, refractory headache, stimulants, triptans | 
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For many migraineurs getting the support they need from family and friends falls short. Dr. Mark Green M.D, director of headache and pain medicine at New York’s Mount Sinai School of Medicine points out that people with migraine typically get head pain, but there are other issues as well. They may feel exhausted, experience nausea, and become light or sound sensitive. “What that means is people tend not to be able to do anything,” according to Dr. Green. This can produce fallout within family dynamics when dinner is not ready on time, or the kids don’t get picked up from school.
Its hard enough dealing with the physical pain of a headache… and even harder when you may have those around you confused, or resentful. Dr. Jack David Schim, MD, co-director of the Headache Center of Southern California recommends patients bring their spouse or other family member to office appointments. Hearing directly from the healthcare provider that migraine is a complicated condition can go a long way in helping people with headache get the support they need.
Here are a few resources for those trying to help friends and family understand headache.
“A Guided Tour of Hell:In the Words of Migraine Sufferers” by Kristine Hatak
“Life and Migraine” a 2005 documentary by Edmund Messina, MD
Migraine Notebook: This free app-available for Apple’s iPhone, iPad and iPod Touch was created by the National Headache Foundation and Glaxosmithkline
HEADWISE National Headache Foundation, Volume 1, Issue 2
According to researchers, lighting has an unusual effect on headache. Dr. Vincent Martin, MD, at the University of Cincinati College of Medicine reported findings from a study that indicate lighting represents a significant trigger for headache in migraineurs. “After adjusting for meteorologic factors associated with thunderstorms, there still remains an increased frequency of headache on lighting days. This suggests that lighting has a unique effect on headache that cannot be explained by other meteorologic factors.”
Martin and his colleagues found the frequency of headache increased by 31%, and that of migraine increased by 28% on days when lighting occurred. All the patients studied were living in Cincinnati or St.Louis and had at least one migraine a month. Stormy weather with lightning was defined as days when one or more lightning strikes occurred within 25 miles of a patient’s home zip code… Neurology Reviews Volume 19 Colby Stong
Women who consume one or more cups of coffee each day have a 22% to 25% decrease in risk of stroke according to Susanna C. Larsson, PhD, of the National Institute of Environmental Medicine in Stockholm.
While some women have avoided drinking coffee because they thought it was unhealthy, Dr. Larsson and her colleagues have found evidence that moderate coffee consumption may decrease the risk of diabetes, liver cancer, and possibly stroke. The study found that women who drank one to two cups, three to four cups, or more than five cups of coffee daily had a lower risk for stroke than women who drank less than one cup a day. The investigators noted that they adjusted for such risk factors as age and smoking while conducting the study.
Something to think about the next time you visit your local Dunkin Donuts or Starbucks…..Neurology Reviews Volume 19
