Comorbidities of sleep disorders in childhood and adolescence: focus on migraine

Abstract

The correlation and/or comorbidity between sleep disorders and headache has been reported in numerous studies, but the exact nature of the association between headache, disordered sleep, and underlying mechanisms remains poorly understood. The bidirectional association between sleep and headache is mediated by a temporal link (headache occurs during sleep, after sleep, and in relationship with sleep stages), by a quantitative relationship (excess, lack, bad quality, short duration of sleep may trigger headache), and by a reciprocal connection (headache may cause sleep disruption and may be associated with several sleep disturbances). This association is most evident for primary headache disorders, especially in childhood. A congenital alteration of neurotransmitter pathways (serotoninergic and dopaminergic) might predispose individuals to both disorders, presenting as sleep–wake rhythm disorder in infancy or as headache disorder later in childhood, as result of this neurotransmitter imbalance. Clinicians should be aware that a complete clinical evaluation of childhood headache includes a careful sleep history, taking into account that the treatment of sleep disturbances could lead to an improvement of headache symptoms and vice versa.

Sleep disturbances among pregnant women with history of migraines: A cross-sectional study

“…Taken together, these findings support hypothesized relationships between sleep deprivation and enhanced response to pain stimuli (27). Furthermore, our results, and those of others (15–16, 25–26) are in general agreement with observations suggesting the importance of sleep disturbances as common triggers of migraine attacks (28). …”

“…The findings from this study are similar with those from previous population-based studies of men and non-pregnant women (15–16, 25) as well as children and adolescents (26). For example, using samples from US adults, Lateef et al reported a significant association between frequent severe headache, including migraine with and without aura, and disordered sleep (25).…”

“…Despite noted study limitations, our results are consistent with a larger body of work documenting associations between migraine and sleep disturbances in men and non-pregnant women (15–16, 25–26). Enhanced understanding of the epidemiology and shared pathophysiological mechanisms between headaches and sleep disturbances is expected to provide important information for enhancing the diagnosis and treatment of these disorders in pregnant women.…”

Insomnia in probable migraine: a population-based study

“…Children with adult-like migraine had a higher prevalence of sleep disorders compared to non-headache controls (disorders of initiating and maintaining sleep; migraine 37.1 % vs controls 9.2 %, disorders of arousals; migraine 59.3 % vs controls 10.2 %) [ 41 ]. Sleep disorders in infancy could be good predictors for the development of headache [ 42 ].…”

NREM Sleep Instability in Pediatric Migraine Without Aura

“…The hypothalamus is crucial in both headache pathogenesis and sleep-wake cycle regulation because of its connection with the anti-nociceptive system [i.e., medulla oblongata, serotoninergic raphe nucleus, noradrenergic locus coeruleus, and periaqueductal gray matter (PAG)] the stimulation mediated by orexin on ventro-lateral part of PAG, and the inhibition on the anti-nociceptive activity in the caudal trigeminal nucleus (5–7).…”