Patients with chronic vs episodic migraine may be at increased risk for sleep apnea and poor sleep quality, according to a study published in Headache.

Chronic Migraine Epidemiology and Outcomes (CaMEO) Study data were collected from web-based cross-sectional surveys conducted between September 2012 and November 2013 to assess migraine frequency and severity. Episodic migraine was defined as <15 headache days per month and chronic migraine, as ≥15 headache days per month for >3 months. CaMEO Study respondents (n=12,810; 91.3% with episodic migraine; 8.7% with chronic migraine) received the Comorbidity/Endophenotype module.

A total of 4739 study participants were found to be at “high risk” for sleep apnea, as assessed with the Berlin Questionnaire. Participants with chronic vs episodic migraine were at particularly high risk for sleep apnea (51.8% vs 35.6%, respectively; P <.001). Among respondents considered to be at “low risk” for sleep apnea, 64.4% of participants had episodic migraine (n=7535) and 48.2% of participants had chronic migraine (n=536). Study participants with episodic vs chronic migraine were found to have greater sleep quality, as indicated by higher values on all components of the Medical Outcomes Study: sleep disturbance (37.9±24.3 vs 53.2±26.9, respectively; P <.001), shortness of breath (15.3±20.6 vs 34.9±29.8, respectively; P <.001), somnolence (32.2±21.2 vs 44.1±23.4, respectively; P <.001), and sleep adequacy (39.2±22.1 vs 34.0±24.2, respectively; P <.001).

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Study limitations include data collection via retrospective self-report. 

“All people with migraine, particularly those with sleep disturbances such as insomnia, could benefit from being educated about behavioral sleep regulation and its likely value in the management of migraine,” noted the study authors. “People with migraine who screen positive for sleep apnea should be referred for additional evaluation and possible [continuous positive airway pressure] treatment, including supportive education to ensure adequate adherence to [continuous positive airway pressure] treatment.”

This study was supported by Allergan plc (Dublin, Ireland). Please see original reference for a full list of authors’ disclosures.


Buse DC, Rains JC, Pavlovic JM, et al. Sleep disorders among people with migraine: results from the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study [published online November 1, 2018]. Headache. doi:10.1111/head.13435