Are Sleep Difficulties Associated With Migraine Attributable to Anxiety and Depression?

Vgontzas, Angeliki; Cui, Lihong; Merikangas, Kathleen R.

doi:10.1111/j.1526-4610.2008.01175.x

Cited by 76 publications

(80 citation statements)

References 45 publications

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“…Both patients with migraine and tension type headache had higher daytime sleepiness as compared to controls. Vgontzas et al (2008) has found that the associations between sleep problems and migraine persisted even after controlling for lifetime and current anxiety and mood disorders [14].…”

Section: Discussionmentioning

confidence: 98%

“…Sleep abnormalities detected among migraineurs were excessive daytime sleepiness, difficulty initiating and maintaining sleep, early morning awakening and daytime fatigue [3]. Vgontzas et al (2008) opined that the sleep disturbances in patients with migraine cannot be explained only by chance association or on the basis of co-morbid depression and anxiety [4]. There could be a biological basis to suggest a common pathway for regulation of sleep and pathogenesis of migraine.…”

Section: Introductionmentioning

confidence: 98%

See 1 more Smart Citation

Sleep disturbances in ‘migraine without aura’ — A questionnaire based study

Karthik

Kulkarni

Taly

et al. 2012

Journal of the Neurological Sciences

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 98%

Sleep disturbances in ‘migraine without aura’ — A questionnaire based study

Karthik

Kulkarni

Taly

et al. 2012

Journal of the Neurological Sciences

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“…In a cross sectional study, Boardman et al [20] identified a dose-response relationship between headache and sleep (eg, trouble falling or staying asleep, feeling tired or worn out): Among 2,662 respondents, headache frequency increased with the severity of sleep complaints, as the OR (adjusted for age and sex) was 2.4 (95% CI, 1.7-3.2) for mild complaints, 3.6 (95% CI, 2.6-5.0) for moderate complaints, and 7.5 (95% CI, 4.2-13.4) for severe sleep complaints. Controlling for anxiety and depression, Vgontzas et al [21] confirmed the association of sleep problems (trouble falling asleep, inadequate sleep) with migraine.…”

Section: Insomniamentioning

confidence: 92%

Sleep and Headache

Rains

Poceta

2010

Curr Treat Options Neurol

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Headache has been linked to a wide range of sleep disorders that may impact headache management. There are no evidence-based guidelines, but the authors believe that literature supports the following clinical recommendations: 1. Diagnose headache according to standardized criteria. Specific diagnoses are associated with increased risk for specific sleep and psychiatric disorders. 2. Collect sleep history in relation to headache patterns. Screening questionnaires and prediction equations are cost-effective. 3. Rule out sleep apnea headache in patients with awakening headache or higher-risk headache diagnoses (cluster, hypnic, chronic migraine, and chronic tension-type headache); patients with signs and symptoms of obstructive sleep apnea warrant polysomnography and treatment according to sleep medicine practice guidelines. There is no evidence for suspending conventional headache treatment in suspected or confirmed cases of sleep apnea. Treatment of sleep apnea with CPAP may improve or resolve headache in a subset of patients. The impact on sleep apnea headache of other treatments for sleep apnea (eg, oral appliances, surgery, weight loss) is largely untested. At a minimum, sedative-hypnotic drugs should be avoided in suspected apneics until the sleep apnea is treated. 4. Among patients with migraine and tension-type headache, insomnia is the most common sleep complaint, reported by one half to two thirds of clinic patients. Patients who suffer from chronic migraine or tension-type headache may benefit from behavioral sleep modification. Pharmacologic treatment may be considered on a case-by-case basis, with hypnotics, anxiolytics, or sedating antidepressants used to manage insomnia, tailoring treatment to the symptom pattern. 5. Individuals with chronic headache are at increased risk for psychiatric disorders. Assessment for depression and anxiety may be warranted when either insomnia or hypersomnia is present. Psychiatric symptoms affect the choice of sedating versus alerting versus neutral pharmacologic agents for headache. 6. All headache patients, particularly those with episodic migraine and tension-type headaches, may benefit from inclusion of sleep variables in trigger management.

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“…[52][53][54] Anxiety and depression may not entirely explain sleep disorders in adult migraineurs. 55 Several studies, the majority based on sleep questionnaires, including some that were population based, have drawn attention to the association between sleep disorders and childhood headache. [56][57][58][59][60][61][62] The association was stronger with migraine than TTH, although those with TTH (including CTTH) may not have been adequately represented.…”

Section: Disorders Of Sleepmentioning

confidence: 99%

Chronic Daily Headache in Children and Adolescents: A Multi-Faceted Syndrome

Seshia

Wang

Abu‐Arafeh

et al. 2010

Can. j. neurol. sci.

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In 1982, Mathew et al first used the term "chronic daily headache" (CDH) to describe headaches that occurred almost daily in adults. 1 Twelve years later, Holden et al published the first report on children with CDH. 2 Since then, there have been at least 21 reports globally. Cumulative knowledge suggests that CDH is not only a common chronic pain syndrome in children (the term will be used to include adolescents), but also a multi-faceted, and often complex one. The appreciation of the many aspects of CDH is pivotal to clinical research and management, and is the thrust of our review. DEFINITIONS AND CLASSIFICATION: THE CONTINUING CONTROVERSY BackgroundIn the almost 30 years since the original description, CDH continues to evoke passionate debate. Globally accepted criteria ABSTRACT: Chronic daily headache (CDH) is a multi-faceted, often complex pain syndrome in children and adolescents. Chronic daily headache may be primary or secondary. Chronic migraine and chronic tension-type are the most frequent subtypes. Chronic daily headache is co-morbid with adverse life events, anxiety and depressive disorders, possibly with other psychiatric disorders, other pain syndromes and sleep disorders; these conditions contribute to initiating and maintaining CDH. Hence, early management of episodic headache and treatment of associated conditions are crucial to prevention. There is evidence for the benefit of psychological therapies, principally relaxation and cognitive behavioral, and promising information on acupuncture for CDH. Data on drug treatment are based primarily on open label studies. The controversies surrounding CDH are discussed and proposals for improvement presented. The multifaceted nature of CDH makes it a good candidate for a multi-axial classification system. Such an approach should facilitate biopsychosocial management and enhance consistency in clinical research.RÉSUMÉ: La céphalée quotidienne chronique chez les enfants et les adolescents, un syndrome à multiples facettes. La céphalée quotidienne chronique (CQC) est un syndrome douloureux à multiples facettes qui est souvent complexe chez les enfants et les adolescents. La céphalée quotidienne chronique peut être primaire ou secondaire. La migraine chronique et la céphalée de tension chronique sont les sous-types les plus fréquents. La CQC est une comorbidité des incidents fâcheux de la vie, de l'anxiété et des troubles dépressifs, possiblement liée à d'autres troubles psychiatriques, syndromes douloureux et troubles du sommeil. Ces états contribuent à amorcer et à maintenir la CQC. Le traitement précoce de la céphalée épisodique et le traitement des comorbidités est donc crucial pour la prévention. Certaines données démontrent un bénéfice des psychothérapies, principalement de la relaxation et de la thérapie cognitivo-comportementale, et l'acuponcture pour le traitement de la CQC semble prometteuse. Les données sur le traitement médicamenteux sont basées principalement sur des études ouvertes. Nous discutons des controverses entourant la CQC et des mo...

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Are Sleep Difficulties Associated With Migraine Attributable to Anxiety and Depression?

Cited by 76 publications

References 45 publications

Sleep disturbances in ‘migraine without aura’ — A questionnaire based study

Sleep disturbances in ‘migraine without aura’ — A questionnaire based study

Sleep and Headache

Chronic Daily Headache in Children and Adolescents: A Multi-Faceted Syndrome

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