Chronic migraine in the first COVID-19 lockdown: the impact of sleep, remote working, and other life/psychological changes

Abstract

Aims The objective of this study was to evaluate the impact of the first Italian COVID-19 lockdown on patients with chronic migraine (CM). Material and methods The study was based on an e-mail survey addressed to CM patients of our headache center. The survey evaluated demographic, life style, sleep, psychological, and migraine features during the COVID-19 lockdown period and the month before. The outcomes were migraine impact on daily life and variation in attack frequency, attack duration, migraine pain intensity, migraine symptomatic drugs use per week, and efficacy. Results Ninety-two patients completed the survey. During the lockdown period, attack frequency was stable in 40,2%, increased in 33,7%, and reduced in 26,1% of patients; attack duration was stable in 55,4%, increased in 23,9%, and reduced in 20,7%. Migraine pain was stable or reduced in 65,2% and increased in 34,8%; number of symptomatic drugs per week was stable in 50%, reduced in 29,3%, and increased in 20,7%; migraine drug efficacy was stable in 73,9%, reduced in 17,4%, and increased in 8,7%. Patients had a HIT-6 score of 64,63 ± 8,81. Significant associations were found with remote working, smoke, education, discontinuation of the therapy performed within headache center, migraine familiarity, sleep, anxiety, perceived stress, concern about future, and COVID-19. Conclusion During the lockdown, approximately half of the patients had a clinical stability, a quarter an improvement, and another quarter a worsening. We identified different migraine-influencing elements; in particular, the remote working could represent an easy way to ameliorate migraineurs’ life. Supplementary Information The online version of this article contains supplementary material available (10.1007/s10072-021-05521-7).

Sleep and sleep-modifying factors in chronic migraine patients during the COVID-19 lockdown

“…Delussi et al showed a sleep quality improvement in 36.3% of their migraineurs, a worsening in 10.4%, and no change in 52.9%. It is important to highlight that we observed a lower improvement rate and a higher percentage of worsening than Delussi et al The same difference was reported for migraine changes between their study and our previous work [ 10 ]. These diverse trends could be explained through the different interview time.…”

“…It is interesting to observe that remote working was associated with sleep latency reduction in our study. We previously described migraine benefit due to remote working [ 10 ]. Also in this case, the improvement could be explained through a better management of the time and the work with a habit reshaping that allow these workers to be more relaxed at bedtime.…”

“…The data were collected using an e-mail survey addressed to patients suffering from chronic migraine followed at our headache center. More detailed information is available in the previous paper [ 10 ]. The questionnaire is available on supplementary materials (S1, S2).…”

Current Perspectives on the Impact of Chronic Migraine on Sleep Quality: A Literature Review

“…This study showed that reduced sleep duration is associated with an increase in migraine attack duration and pain. 69 …”

“…This study showed that reduced sleep duration is associated with an increase in migraine attack duration and pain. 69 Stress is the trigger for poor sleep and migraine chronification. 21,70 Quarantine is a lifestyle that increases stress.…”