Poor sleep quality is prevalent among patients with probable migraine and is associated with an exacerbation of probable migraine symptoms, according to research published in the Journal of Headache and Pain.
Using data from the Korean Headache Sleep Study (KHSS), researchers sought to assess the prevalence and clinical impact of poor sleep quality in individuals with probable migraine compared with migraine patients. The researchers conducted the survey with a random sample of the general population of Korea. They applied the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality.
Participants with an index >5 were defined as having poor sleep quality. Data on subjective quality of sleep, latency of sleep, duration of sleep, habitual sleep insufficiency, disturbance of sleep, use of hypnotics, and dysfunction at daytime were also collected. The study screened for anxiety with the Goldberg Anxiety Scale and collected data on depression with the Patient Health Questionnaire-9 (PHQ-9).
A total of 7430 people were interviewed for the study, with 2695 completing the survey entirely. Results showed that prevalence of migraine was 5.3%, probable migraine was 14.1%, and poor sleep quality was 26.5%. It also showed that 35.3% of participants with probable migraine had poor sleep quality.
Participants with poor sleep quality showed increased headache frequency, intensity, and impact. The study also found that poor sleep quality is a common comorbidity for migraneurs and individuals with probable migraine. Anxiety, depression, and headache frequency were associated with poor sleep quality. Participants with probable migraine had higher latency of sleep, duration of sleep, sleep disturbance, and higher daytime dysfunction scores compared with the non-headache participants.
In a multivariable linear regression analysis, anxiety (P < .001), depression (P < .001), and headache frequency per month (P < .031) were significant independent factors association with PSQI scores in participants with probable migraine.
Limitations of the study include questionnaires validated for migraine, but not for probable migraine, a limited sample size, and the fact that some medication for acute and preventive migraine treatment may influence quality of sleep.
The investigators conclude by recommending the treatment of comorbidities such as anxiety and depression with pharmacological and non-pharmacological treatments such as relaxation techniques, cognitive behavior therapy, and mindfulness to improve symptoms of probable migraine by improving sleep quality.
The study was supported by a grant from the Korean Academy of Medical Sciences and a grant of the Basic Science Research Program through the National Research Foundation (NRF) funded by the Ministry of Education, Republic of Korea. Please refer to reference for a complete list of authors’ disclosures.
Reference
Song T, Cho S, Kim W, Yang KI, Yun C, Chu MK. Poor sleep quality in migraine and probable migraine: a population study. J Headache Pain. 2018; 19:58.