Sleep quality and migraines are intimately linked. Poor sleeping has long been known to have an association with migraine attacks, in a significant percentage of people. What has surprised both patients and clinicians is the realisation that a single night’s sleep quality is predictive of episodic migraines, over the next six weeks. This development was noted in a study presented at the American Headache Society’s annual meeting.
Dr Angela Vgontzas and her team noted that a ‘baseline’ of poor sleep quality was associated with a 22 percent higher rate of episodic migraine recurrence, every day, over the next six weeks. This is the first study to show such a long lasting link between the two factors. Poor sleep quality included factors such as sleep disturbances, snoring, shortness of breath and somnolence.
THE STUDY
Dr Vgontzas studied 98 episodic migraineurs, as defined by the International Classification of Headache Disorders-3 criteria. The data pointed to an average age of 35, with 5 migraine attacks per month. 88 percent of the patients were female.
At the start of the study, participants were given questionnaires for the following:
- Depressive symptoms
- Stress
- Sleep quality
The patients’ migraine frequency were tracked via daily electronic diary entries over a 6 week period.
RESULTS
The collated data showed 46 percent of patients experienced poor sleep quality; 18 percent scored high in depressive symptoms and 52 percent scored moderate to high for stress symptoms. 26.5 percent of patients were taking migraine prophylactic medication
823 migraine headaches were reported by the patients for the duration of the study.
ANALYSIS
The researchers used sophisticated models to find possible correlations between the pre-study questionnaire variables and headache occurrence.
Poor sleep quality was correlated with a 22 percent increased incidence of migraine headache recurrence.
Moderate to high stress correlated with a 12 percent increased incidence of migraine headache recurrence.
Dr Vgontzas suggested that this correlation would possibly be able to identify episodic migraineurs at risk of progressing to chronic migraines. This is due to the already known correlation between poor sleep and chronic migraines. A previous large CaMEO survey of close to 13,000 migraineurs showed that chronic migraineurs had a statistically higher rate of poor sleep quality than episodic migraineurs.
LEAD AUTHOR’S REFLECTIONS
Dr Vgontzas reflected that though ‘we know that people with higher frequency of migraine report more sleep problems’, we do not yet know ‘which comes first’
She postulated there was an underlying mechanism driving both symptoms to occur with each other; this mechanism could be ‘genetic, biological, or behavioural’. The relationship between stress and sleep was something worth investigating in the future.