Weekend Migraine

Abstract

It is a general belief that migraine attacks are prone to occur on days off. Only a few studies, however, have addressed this issue. The objective of this study was to investigate the periodicity of migraine with respect to weekly (circaseptan) variations. Eighty-nine females of fertile age who had participated in a previous questionnaire-based study volunteered to record in detail every migraine attack for 12 consecutive months. Eighty-four patients completed recordings for a mean of 311 days (s.d. = 95.9, range 30-365). A total of 2314 attacks were recorded. Migraine occurrence was almost equally distributed during the week, except on Sundays, when there were significantly fewer attacks (t = -4.42, d.f. = 83, P < 0.001). A Mantel-Haenszel estimate of the relative risk of having an attack on a holiday vs. another day, not Sundays included, was 0.64 (95% CI 0.49-0.85). Our study suggests that days off protect against migraine.

Seasonal Variation of Migraine in an Arctic Population

“…Migraine is a periodic disorder that may be triggered by a number of internal and external factors 1 . Attacks may occur in a certain periodic patterns with peaks at weekends, at onset of menstruation or influenced by seasons 2‐4 . Migraine patients seen at our practice in Tromsø typically suffer more from headache in the Arctic light season 5 .…”

“…1 Attacks may occur in a certain periodic patterns with peaks at weekends, at onset of menstruation or influenced by seasons. [2][3][4] Migraine patients seen at our practice in Tromsø typically suffer more from headache in the Arctic light season. 5 In a questionnaire study in North Norway, 12% of patients with migraine experienced more frequent attacks in the light season compared with 6% in other headache patients.…”

Insomnia and Circadian Variation of Attacks in Episodic Migraine

“…However, all in all the circadian temporal patterns, with very few attacks during the night, indicate that sleep rather protects against migraine than triggers it. This is also indirectly supported by the observation that migraine attacks occurred less frequent on Sundays compared to other days of the week in the same population 23 . An alternative explanation is that insomnia actually is a premonitory symptom of migraine 24 .…”

“…This is also indirectly supported by the observation that migraine attacks occurred less frequent on Sundays compared to other days of the week in the same population. 23 An alternative explanation is that insomnia actually is a premonitory symptom of migraine. 24 Nor can we exclude that episodic migraine may contribute to chronic insomnia.…”

Answer to comment on “sleep quality, arousal and pain thresholds in migraineurs: a blinded controlled polysomnographic study”

“…Even small delays in bedtime can probably release an attack if the need for sleep is increased. Long sleep is not the most frequently reported migraine trigger and the importance of long sleep itself might be questioned as weekend migraine seems infrequent [8]. To speculate, long sleep periods are probably associated with increased sleep depth which itself seems to be a risk factor for migraine [2,9].…”