Associations Between Sleep Quality and Migraine Frequency

Abstract

Migraine has been associated with sleep disturbances. Relationship between sleep quality and migraine frequency is yet to be determined. The present study aimed to investigate sleep disturbances among low-frequency, moderate-frequency, high-frequency, and chronic migraineurs, with and without auras, with well-controlled confounding variables.This cross-sectional controlled study included 357 subjects from an outpatient headache clinic in Taiwan. Standardized questionnaires were utilized to collect demographic, migraine, sleep, depression, anxiety, and restless leg syndrome characteristics in all participants. According to frequency of migraine attacks, patients were divided into 4 groups: with 1 to 4 migraine days per month, 5 to 8 migraine days in a month, 9 to 14 migraine days in a month, and >14 migraine days per month. The Pittsburgh Sleep Quality Index (PSQI) and subgroup items were used to evaluate sleep quality. The association between migraine frequency and sleep quality was investigated using multivariable linear regression and logistic regression.The PSQI total score was highest in patients with high frequent migraine (10.0 ± 3.4) and lowest in controls (7.0 ± 3.4) with a significant trend analysis (P for trend = 0.006). Migraine frequency had an independent effect on the items “Cannot get to sleep within 30 minutes” (P < 0.001), “Wake up in the middle of the night or early morning” (P < 0.001), “Bad dreams” (P = 0.001), “Pain” (P = 0.004), and “Quality of sleep” (P < 0.001). The result showed the effect of migraine frequency in both the aura-present (P for trend = 0.008) and the aura-absent subgroups (P for trend = 0.011).High migraine frequency correlates with poor sleep quality and a higher prevalence of poor sleepers. These associations occur in migraine with aura and without aura.

Sleep Disorders Among People With Migraine: Results From the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study

“…47 Sleep disturbances were 5-fold more likely in those with migraine; the likelihood of sleep disturbance increased as headache frequency increased, 44 with some investigators reporting that this effect reaches a plateau when migraine headaches are ≥9 days per month. 43 …”

OnabotulinumtoxinA effectiveness on chronic migraine, negative emotional states and sleep quality: a single-center prospective cohort study

“…Higher prevalence of poor sleep quality was also noted in patients with migraine compared to those without migraine [17–21], while high migraine frequency was shown to correlate with poor sleep quality and a higher prevalence of poor sleepers in chronic migraineurs [21]. …”

“…This seems notable given the reported association of higher migraine frequency with higher scores for certain domains of PSQI such as “cannot get to sleep within 30 minutes,” “wake up in the middle of the night or early morning,” and “bad dreams” among migraineurs [21]. …”

Sleep Disorders and Migraine: Review of Literature and Potential Pathophysiology Mechanisms

“…Patients with migraine also report increased frequency of nightmares. 64,65 Although the significance of this is unknown, it may reflect more frequent awakenings, such as during REM sleep. Further research should explore whether self-report of nightmares reflects alterations in sleep architecture among patients with migraine.…”