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5. HEADACHE ATTRIBUTED TO HEAD AND/OR NECK TRAUMA 6. HEADACHE ATTRIBUTED TO CRANIAL OR CERVICAL VASCULAR DISORDER 7. HEADACHE ATTRIBUTED TO NON-VASCULAR INTRACRANIAL DISORDER 8. HEADACHE ATTRIBUTED TO A SUBSTANCE OR ITS WITHDRAWAL 9. HEADACHE ATTRIBUTED TO INFECTION 10. HEADACHE ATTRIBUTED TO DISORDER OF HOMOEOSTASIS 10.1. Headache attributed to hypoxia and/or hypercapnia 10.1.1. High-altitude headache [W94] 10.1.2. Diving headache 10.1.3. Sleep apnoea headache [G47.3] 10.2. Dialysis headache [Y84.1] 10.3. Headache attributed to arterial hypertension [I10] 10.4. Headache attributed to hypothyroidism [E03.9] 10.5. Headache attributed to fasting [T73.0] 10.6. Cardiac cephalalgia [code to specify aetiology] 10.7. Headache attributed to other disorder of homoeostasis [code to specify aetiology] Bibliography11. HEADACHE OR FACIAL PAIN ATTRIBUTED TO DISORDER OF CRANIUM, NECK, EYES, EARS, NOSE, SINUSES, TEETH, MOUTH OR OTHER FACIAL OR CRANIAL STRUCTURES 12. HEADACHE ATTRIBUTED TO PSYCHIATRIC DISORDER 

IHS	Diagnosis	ICD-10
10.1.3	Sleep apnoea headache [G47.3]	G44.882

Diagnostic criteria:

Recurrent headache with at least one of the following characteristics and fulfilling criteria C and D:
1. occurs on >15 days per month
2. bilateral, pressing quality and not accompanied by nausea, photophobia or phonophobia
3. each headache resolves within 30 minutes
Sleep apnoea (Respiratory Disturbance Index ≥5) demonstrated by overnight polysomnography
Headache is present upon awakening
Headache ceases within 72 hours, and does not recur, after effective treatment of sleep apnoea

Comments:

Although morning headache is significantly more common in patients with sleep apnoea than in the general population, headache present upon awakening is a non-specific symptom which occurs in a variety of primary and secondary headache disorders, in sleep-related respiratory disorders other than sleep apnoea (eg, Pickwickian syndrome, chronic obstructive pulmonary disorder), and in other primary sleep disorders such as periodic leg movements of sleep. A definitive diagnosis of 10.1.3 Sleep apnoea headache requires overnight polysomnography.

It is unclear whether the mechanism of 10.1.3 Sleep apnoea headache is related to hypoxia, hypercapnia or disturbance in sleep.

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IHS vs. ICD-10

To facilitate headache diagnosis in daily practice, the classification provides the corresponding WHO ICD-10NA codes for each IHS code.

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