The effect of posterior hypothalamus region deep brain stimulation on sleep

Cephalalgia. 2014 Mar;34(3):219-23. doi: 10.1177/0333102413505241. Epub 2013 Sep 17.


Background: Early observations by von Economo showed that the posterior part of the hypothalamus (PH) plays a prominent role in sleep-wake regulation. The PH is a candidate area involved in cluster headaches and other trigeminal autonomic cephalalgias (TACs) and is targeted for deep brain stimulation (DBS).

Case reports: Sleep studies in two men, 69- and 39-years-old, with pre-existing sleep disorders, before and after PH-DBS for pharamacoresistant cluster headache and SUNCT syndrome showed that PH-DBS led to a dramatic alteration of the patients' sleep patterns. This coincided with an improvement of the predominantly diurnal TACs, suggesting a PH-DBS-induced change in sleep patterns. Hypnograms after DBS demonstrated disrupted sleep and a prolonged period of wakefulness after midnight in both patients, which was reproduced the second night.

Conclusions: PH-DBS, a promising treatment for severe refractory TACs, affects sleep quality and pre-existing sleep disorders. This needs to be considered when treating patients with PH-DBS.

Keywords: DBS; Parasomnia; REM behavioural disorder; cluster headache; trigeminal autonomic cephalalgias.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cluster Headache / diagnosis
  • Cluster Headache / physiopathology*
  • Cluster Headache / therapy*
  • Deep Brain Stimulation / methods
  • Humans
  • Hypothalamus
  • Male
  • SUNCT Syndrome / diagnosis
  • SUNCT Syndrome / physiopathology*
  • SUNCT Syndrome / therapy*
  • Sleep Wake Disorders / diagnosis
  • Sleep Wake Disorders / physiopathology*
  • Sleep Wake Disorders / prevention & control*
  • Sleep*
  • Treatment Outcome