Sleep features and central sensitization symptoms in primary headache patients

Abstract

BackgroundAssociation between sleep disorders and headache is largely known. The aim of the present study was to evaluate sleep quality and quantity in a large cohort of primary headache patients, in order to correlate these scores with symptoms of central sensitization as allodynia, pericranial tenderness and comorbidity with diffuse muscle-skeletal pain.MethodsOne thousand six hundreds and seventy primary headache out patients were submitted to the Medical Outcomes Study (MOS) within a clinical assessment, consisting of evaluation of frequency of headache, pericranial tenderness, allodynia and coexistence of fibromyalgia syndrome (FM).ResultsTen groups of primary headache patients were individuated, including patients with episodic and chronic migraine and tension type headache, mixed forms, cluster headache and other trigeminal autonomic cephalalgias. Duration but not sleep disturbances score was correlated with symptoms of central sensitization as allodynia and pericranial tenderness in primary headache patients. The association among allodynia, pericranial tenderness and short sleep characterized chronic migraine more than any other primary headache form. Patients presenting with FM comorbidity suffered from sleep disturbances in addition to reduction of sleep duration.ConclusionSelf reported duration of sleep seems a useful index to be correlated with allodynia, pericranial tenderness and chronic headache as a therapeutic target to be assessed in forthcoming studies aiming to prevent central sensitization symptoms development.

Effects of Botulinum Toxin A on Allodynia in Chronic Migraine: An Observational Open-Label Two-Year Study

“…Allodynia may thus be a characteristic of CM, correlated with other invalidating symptoms as anxiety, depression, and short sleep time [18], as emerged also in the present patients group.…”

“…All patients reported on interview their sleep features, according to the Medical Outcomes Study (MOS) [16], on a scale we previously applied in large headache populations [17,18]. For the present analysis, we considered the sleep quantity score (MOS2); lower scores indicated worse sleep problems, referring to hours of sleep for night in the last week.…”

Gender, Headaches, and Sleep Health in High School Students

“…2 This relationship is bidirectional, in that shorter sleep duration is associated with increased headache frequency and severity, with sleep insufficiency and shorter/poor sleep during the previous day acting as headache triggers. 11 While chronic headache is negatively associated with adolescent sleep health problems in general, associations among headache, gender, and sleep health are also suggested. 6 Studies indicate that central sensitization to pain, greater degree of allodynia and pericranial tenderness, secondary hyperalgesia, and gonadal hormone influence on analgesic response in females, when compared with males, may account for the increased prevalence and reported severity of headache in females, [11][12][13] which in turn, could potentially contribute, in part, to more sleep difficulties in females with headache.…”

Adolescence and Sleep

“…Sleep deprivation and epilepsy have a complex bidirectional relationship because lack of sleep can increase the likehood of seizure recurrence due the activating interictal activity and recurrent oxygen desaturation [36][37][38]. Chronic headache has also been associated with short sleep duration with increased frequency and severity acting as headache triggers [39][40][41].…”