{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:44:55Z","timestamp":1792806295250,"version":"4.5.0"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,12,30]],"date-time":"2014-12-30T00:00:00Z","timestamp":1419897600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Cluster headache (<jats:styled-content style=\"fixed-case\">CH<\/jats:styled-content>) is a primary headache disorder characterized by severe attacks of unilateral pain following a chronobiological pattern. There is a close connection with sleep as most attacks occur during sleep. Hypothalamic involvement and a particular association with rapid eye movement (<jats:styled-content style=\"fixed-case\">REM<\/jats:styled-content>) sleep have been suggested. Sleep in a large, well\u2010characterized population of <jats:styled-content style=\"fixed-case\">CH<\/jats:styled-content> patients was investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Polysomnography (<jats:styled-content style=\"fixed-case\">PSG<\/jats:styled-content>) was performed on two nights in 40 <jats:styled-content style=\"fixed-case\">CH<\/jats:styled-content> patients during active bout and one night in 25 age, sex and body mass index matched controls in hospital. Macrostructure and other features of sleep were analyzed and related to phenotype. Clinical headache characterization was obtained by semi\u2010structured interview.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ninety\u2010nine nights of <jats:styled-content style=\"fixed-case\">PSG<\/jats:styled-content> were analyzed. Findings included a reduced percentage of <jats:styled-content style=\"fixed-case\">REM<\/jats:styled-content> sleep (17.3% vs. 23.0%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.0037), longer <jats:styled-content style=\"fixed-case\">REM<\/jats:styled-content> latency (2.0 vs. 1.2\u00a0h, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.0012) and fewer arousals (7.34 vs. 14.1, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.003) in <jats:styled-content style=\"fixed-case\">CH<\/jats:styled-content> patients. There was no difference in prevalence of sleep apnea between patients (38%) and matched controls (32%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.64) although the apnea index in patients was numerically higher (mean apnea\u2212hypopnea index 10.75 vs. 4.93). No temporal association between nocturnal attacks (<jats:italic>n<\/jats:italic>\u00a0=\u00a045) and particular sleep stages was observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>To date, this is the largest study of sleep in <jats:styled-content style=\"fixed-case\">CH<\/jats:styled-content>. It is demonstrated that <jats:styled-content style=\"fixed-case\">REM<\/jats:styled-content> sleep is affected which is in line with our current understanding of <jats:styled-content style=\"fixed-case\">CH<\/jats:styled-content> and hypothalamic involvement in the regulation of this sleep stage. Further, fewer arousals were found in <jats:styled-content style=\"fixed-case\">CH<\/jats:styled-content> patients but no association between apnea events or specific sleep stages. The findings support a central role of the hypothalamus and arousal systems in <jats:styled-content style=\"fixed-case\">CH<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.12623","type":"journal-article","created":{"date-parts":[[2014,12,30]],"date-time":"2014-12-30T14:23:38Z","timestamp":1419949418000},"page":"656","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":63,"title":["Sleep in cluster headache \u2212 beyond a temporal rapid eye movement relationship?"],"prefix":"10.1111","volume":"22","author":[{"given":"M. C. 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