Dr. Çigdem Şen

Headaches are very common and not every headache is the same. The two most common types are migraine and tension headache. The distinction is important because it directly determines treatment.

Migraine is a throbbing, moderate-to-severe pain, usually in one side of the head. Nausea and discomfort from light and sound are frequently accompanied; increases with movement. Tension-type headache is a squeezing, pressing pain on both sides of the head, and it generally does not restrict daily activities as much as migraine.

It is useful to keep a pain diary during the evaluation: the frequency, duration, triggers of pain and medications used are recorded. Treatment is planned preventively both during attacks and in frequently recurring situations.

The majority of headaches are primary headaches; that is, it is not due to another underlying disease. In these cases, diagnosis is made by history and examination, imaging is often not required.

However, some findings require further examination: sudden onset and very severe pain, accompanied by fever or neck stiffness, significant change in the nature of the pain, emergence of neurological findings, new-onset headache over the age of fifty, and new pains seen in immunocompromised people.

If these findings are present, imaging and, if necessary, additional examinations are planned. If there are no findings, early imaging does not change the diagnosis. In this case, determining the type of pain and planning the appropriate treatment is a priority.

Sleep is a period of reorganization of the brain, not rest. Therefore, sleep problems are closely related to neurological complaints. Excessive daytime sleepiness, distraction and headaches are common consequences.

During the evaluation, sleep patterns are first questioned: bedtime-wake-up times, time to fall asleep, night awakenings and snoring. If respiratory arrest during sleep is described, this is also addressed. If left untreated, it can also affect cardiovascular health.

Sleep laboratory examination is planned when necessary. Conditions that disrupt sleep, such as restless legs syndrome, are also evaluated. Treatment consists of sleep hygiene regulations and an approach aimed at the underlying cause.