Psychiatric and sleep abnormalities in school-age children with migraine

Abstract

Background: Migraine is a primary headache that commonly starts in childhood and adolescent's periods with great negative impacts on the educational and psychosocial performances of its sufferers. The objectives of this work were to study the existence and types of sleep and psychiatric abnormalities in school-age children with migraine (SCM). Methods: The study was conducted on 40 SCM and 20 age-and sex-matched healthy control subjects (HCS) submitted to history taking, neurological examination, Pediatric Migraine Disability Assessment (PedMIDAS) questionnaire, Child Behavior Checklist (CBCL), Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD), Pittsburgh Sleep Quality Index (PSQI) and one-night polysomnography (PSG). Results: The study showed a high incidence of psychiatric and sleep abnormalities in SCM. The most common psychiatric disorders were anxious depressed symptoms, withdrawal depressed symptoms, social problem, somatic complaints, and attention problems. At the same time, SCM experienced decreased sleep quality, excessive daytime sleepiness (EDS), and PSG abnormalities in the form of decreased total sleep time (TST) and sleep efficiency (SE) in addition to increased sleep latency, wake after sleep onset (WASO), arousal index (AI), and REM sleep without atonia index. Conclusion: Sleep and psychiatric abnormalities are common underdiagnosed pediatric migraine comorbidities greatly reducing headache control and school performance in this very important period of psychosocial development.

Migraine and Mood in Children

“…El-Heneedy and colleagues [ 34 ] showed that increased anxious-depressed symptoms among school children with migraine (SCMs) were positively correlated with disabilities following repeated episodes of migraine [ 34 ]. In parallel, SCMs showed competence and behavioral problems with increased depressive symptoms, social problems, somatic issues, and difficulties with attention.…”

“…In parallel, SCMs showed competence and behavioral problems with increased depressive symptoms, social problems, somatic issues, and difficulties with attention. These consecutively impaired SCMs in their free-time and social activities [ 34 ]. Other studies [ 35 , 36 ] have also found increased anxiety and depression in children with migraine.…”

“…A high incidence of psychiatric and sleep abnormalities have been found in school-aged children with migraine [ 34 ]. The most common psychiatric disorders were anxiety and depression, withdrawal depressed symptoms, social issues, and problems with attention.…”

“…The most common psychiatric disorders were anxiety and depression, withdrawal depressed symptoms, social issues, and problems with attention. Sleep disturbances were present as low sleep quality, excessive daytime sleepiness, and decreased total sleep time, among several other abnormal sleep indicators [ 34 ]. Considering sleep hygiene may help patients recover from the vicious sleep-headache cycle, where children are affected by a nocturnal attack that disturbs sleep, and sleep disturbances exacerbate headaches [ 75 ].…”

Subjective sleep quality and objective sleep physiology in migraineurs: a meta-analysis

“…There were no participants <18 years of age in the PSQI analysis or the MIDAS and PSQI correlational analysis due to a lack of available data. Eleven studies measured PSG in adults [15][16][17][18][19][20] and children [21][22][23][24][25] , with and without migraine. One study 16 compared migraineurs PSG in the pre-, mid-and post-ictal phase, and thus it was not appropriate to extract a single value for this data.…”