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Congested head in the morning. Relieves with Imitrex. History of sinus surgery. What is the action of Imitrex?

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I wake with a headache many days of the week. But if i dont get the headache i get this really heavy congested head and i have to sleep an extra four hours. The whole day my head will fill heavy. But if i use imitrex before i go to sleep i wake with a clear head. I use a auto CPAP machine. I have allergies and sinus problems. What is the imitrex doing that clears my head? If i figure that out maybe i can figrure out what is causing the congested head. I have had sinus surgery to help nasil breathing. I have been getting the heavy head thing for years and it seems to be getting worse with headaches. If it is sinus or allergy would Imitrex clear it up? If it is sleep apnea would imitrex clear that? So how does Imitrex keep my congested head clear? Maybe it isnt congestion?? What could be causing this thick heavy congested head thing that can lead to a headache but imitrex can prevent if i take 50+mg before bed. I have no insurance and cant afford specialists.
Thank you
Posted Thu, 3 May 2012 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Sumit Bhatti 4 hours later
Hi,

Thank you for your query.

1. Imitrex (Sumatriptan) is a drug used specifically in the treatment of Migraine.

2. Imitrex will not cure allergy. However, it causes vaso-constriction and hence will reduce congestion and pain (headache) due to sinusitis.

3. Sinus congestion will usually be accompanied by nasal discharge or a post nasal drip, especially when it is relieved. Allergy will usually be accompanied by sneezing, nasal discharge (rhinorrea) or nasal obstruction.Do you have these symptoms?

4. If you undergo a plain CT PNS (para Nasal Sinuses), and it is clear, then you have Migraine. Then your heavy congested feeling in the head is unrelated to sinusitis.

5. If your sinusitis still persists after the surgery, it will show up in the scan. There is no way of looking into all the sinuses.

6. Use of the CPAP machine may also cause congestion due to air pumped into the nose and sinuses under pressure. Fungal sinusitis may also exist.

I hope I have answered your query. If you have any follow up queries, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Congested head in the morning. Relieves with Imitrex. History of sinus surgery. What is the action of Imitrex? 4 hours later
Thank you for replying to my question. I am puzzled by this problem I have because of the following. First let me answer some of the questions you asked.

3. Sinus congestion will usually be accompanied by nasal discharge or a post nasal drip, especially when it is relieved. Allergy will usually be accompanied by sneezing, nasal discharge (rhinorrea) or nasal obstruction.Do you have these symptoms?

I don't think I have those things. I haven't sneezed in years. Sometimes I do get some blockage in my right sinus. But, if I do have allergy and sinus problems would Imitrex help these things? If it won't help these things then I don't think my problem with waking with a cloudy head and headache is related to sinus and allergy because when I use the Imitrex I don't have those problems.???

4. If you undergo a plain CT PNS (para Nasal Sinuses), and it is clear, then you have Migraine. Then your heavy congested feeling in the head is unrelated to sinusitis.

Yes, I have had this done and they didn't see anything. So this heavy cloudy head isn't related to sinus problems or allergy??

6. Use of the CPAP machine may also cause congestion due to air pumped into the nose and sinuses under pressure. Fungal sinusitis may also exist.

I use a CPAP, but if I don't I will for sure wake with a headache. I have had this issue of waking with a heavy,cloudy, dull head for years, long before I used a CPAP machine.

I am still confused. What could be going on in my head that when I wake I have this dull, cloudy, heavy, full, swollen head, that requires hours of extra sleep to feel rested and can sometimes lead to headaches, but if I take Imitrex before I go to sleep I will wake with a clear head and not need anymore sleep.

I don't think this is pre-migraine symptoms because I have never read this type of think relating to migraines. Or could it?? If not migraine or sinus or allergy or CPAP what could it be and how can I figure it out.

I have been struggling with this issue for ten to twenty years.

Thanks XXXXXXX


 
 
Answered by Dr. Sumit Bhatti 8 hours later
Hi,

Thank you for writing back.

1. You need a sleep study or a PSG (PolySomnoGram) with and without the CPAP (Continuous positive airway pressure). If your Sleep Apnea Syndrome is severe, it explains why you had these symptoms before using the CPAP.

2. Is it so that you wake up feeling cloudy and heavy, needing more sleep only when you do not use the CPAP? If this does not happen with the CPAP, then these symptoms are due to OSAS. (Obstructive Sleep Apnea Syndrome).

3. If you have no symptoms of sinusitis and your scans have not detected sinusitis, then it is ruled out. However, nasal obstruction may not show up. That will require rhinomanometry.

4. Is it that you do not have to use the CPAP when you take Imitrex and still feel fine after waking up? Imitrex cause vaso-constriction and de-congestion, thereby relieving the obstruction and congestion.

5. Hence your underlying problem seems to be Sleep Apnea rather than Migraine.

I hope I have answered your query. If you have any follow up queries, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
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