Stress and sleep duration predict headache severity in chronic headache sufferers

Abstract

The objective of this study was to evaluate the time-series relationships between stress, sleep duration, and headache pain among patients with chronic headaches. Sleep and stress have long been recognized as potential triggers of episodic headache (< 15 headache days/month), though prospective evidence is inconsistent and absent in patients diagnosed with chronic headaches (≥ 15 days/month). We reanalyzed data from a 28-day observational study of chronic migraine (n = 33) and chronic tension-type headache (n = 22) sufferers. Patients completed the Daily Stress Inventory and recorded headache and sleep variables using a daily sleep/headache diary. Stress ratings, duration of previous nights' sleep, and headache severity were modeled using a series of linear mixed models with random effects to account for individual differences in observed associations. Models were displayed using contour plots. Two consecutive days of either high stress or low sleep were strongly predictive of headache, whereas two days of low stress or adequate sleep were protective. When patterns of stress or sleep were divergent across days, headache risk was increased only when the earlier day was characterized by high stress or poor sleep. As predicted, headache activity in the combined model was highest when high stress and low sleep occurred concurrently during the prior 2 days denoting an additive effect. Future research is needed to expand on current findings among chronic headache patients and to develop individualized models that account for multiple simultaneous influences of headache trigger factors.

Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion

“…18,19,105,106 Sleep durations of 7-8 or 8-9 hours were consistently associated with reduced pain symptoms. 18,[105][106][107][108][109] Results were less consistent for sleep durations of 6-7 hours and 9 or more hours, primarily due to the small number of studies examining sleep durations in these time ranges.…”

“…Sleep durations below 5 hours were associated with increased pain in all of these study types. 18,19,[105][106][107][108][109][110] Increased pain symptoms were associated with sleep duration of less than 6 hours in four studies (three self-report and one objective monitoring). 18,19,105,106 Sleep durations of 7-8 or 8-9 hours were consistently associated with reduced pain symptoms.…”

Frequency and Pattern of Headache in Medical Residents and Non-Medical Students in a Tertiary Care Teaching Hospital in North India

“…Similar triggers for headache have been shown previously. [21][22][23][24][25][26] Previous studies have also linked sleep deprivation to headaches. 27,28 Most of the medical residents undergo self-medication and only a few consult physicians for headache.…”

Validation of the Revised Illness Perception Questionnaire for Migraine Patients and the Effects of Earthquake Experience on Perception of Disease

“…[3,4] Çalışmamamızın sonuçlarına göre akut ağır bir stresör depresyon skalasında değişiklik yapması-na rağmen hastalık şiddeti aynı bireylerde hastalık algısını çok fazla etkilememiştir. Migren hastaları ağır bir yaşam olayından sonra dahi neredeyse benzer hastalık algısına sahiptirler.…”

“…Genetik, yaşam koşulları ve çevresel faktörler gibi emosyonel durumlar da hastalığın şiddetine etki eder. [3,4] Hastalarda kronik bir hastalığa sahip olma dü-şüncesi, tedavide yaşanan güçlükler, hastalığın getirdiği fiziksel ve psikososyal sorunlar emosyonel durumu bozar.…”