Sleep Predicts Migraine Recurrence

— Sleep quality may identify patients at risk of developing chronic migraine

Sleep quality at a single time point was tied to headaches occurring over the next 6 weeks among people with episodic migraine, a prospective study presented at the American Headache Society annual meeting showed.

Baseline poor sleep quality in episodic migraine patients was associated with a 22% higher rate of headache recurrence on each day over the following 6 weeks, reported Angeliki Vgontzas, MD, of Brigham and Women’s Hospital in Boston, and co-authors.

“This is the first study to show that a baseline report of poor sleep quality may be able to identify patients with higher future headache burden,” Vgontzas told MedPage Today.

“Taken together with other studies that report increased sleep complaints in those with chronic migraine, we believe that baseline assessment of poor sleep quality in those with episodic migraine may help identify those at risk of developing chronic migraine,” she added.

Disordered sleep, poor sleep quality, and insufficient or excessive sleep duration are known triggers of migraine and tension-type headaches. The large, population-based CaMEO survey of nearly 13,000 migraine patients showed that people with chronic migraine were more likely to report poor sleep quality — including sleep disturbance, snoring, shortness of breath, and somnolence — and were less likely to report sleep adequacy than episodic migraine patients.

In their analysis, Vgontzas and colleagues studied 98 adults with episodic migraine, defined by International Classification of Headache Disorders-3 criteria. Participants had an average age of 35 and 88% were women; they had a baseline average of five migraine headaches a month.

At the start of the study, participants completed questionnaires about depressive symptoms (Center for Epidemiological Studies Depression scale; CES-D), stress (10-item Perceived Stress Scale; PSS-10), and sleep quality (Pittsburgh Sleep Quality Index; PSQI). Over the next 6 weeks, participants reported headaches in daily morning and evening electronic diaries.

Baseline data showed that 46% of participants had poor sleep quality (PSQI score ?5), 18% had high depressive symptoms (CES-D score ?16), and 52% reported moderate or high stress levels (PSS-10 score ?14). About one in four participants (26.5%) were using migraine prophylactic medication.


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