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January 1992

Idiopathic Intracranial Hypertension Without Papilledema: Related to Sleep Apnea?

Author Affiliations

Departments of Psychiatry and Neurology Rhode Island Hospital Providence, RI 02903

Arch Neurol. 1992;49(1):14. doi:10.1001/archneur.1992.00530250018004

To the Editor.  —I read with interest the article entitled "Idiopathic Intracranial Hypertension Without Papilledema," published in the April issue of the Archives.1 I could not help but wonder, however, if some patients had obstructive sleep apnea (OSA).First, that only three of the 10 patients had a decreased level of protein in the cerebrospinal fluid tends to argue that the other seven patients might not have had pseudotumor cerebri. Second, eight of the 10 patients were obese, which is strongly associated with OSA.2 Third, all patients had headaches on awakening, which is a common symptom in OSA.3 Morning nausea, although not common, is also reported in OSA.3 Fourth, that four patients were hypertensive is also linked to OSA.4 Fifth, apnea itself is known to cause increases in intracranial pressure.In 1989, Jennum and Borgesen5 used epidural pressure monitors to study six otherwise normal