Sleep Quality Influences Migraine Frequency And Disability

Sleeping Woman - Migraine Blog

 

Sleep Quality Directly Effects How Often You Get Migraines (1)

Tests conducted by researchers at the University of Mississippi, U.S.A have shown a strong correlation between poor quality of sleep and the frequency of migraine episodes as well as the disabilities that go with the condition.

The Pittsburgh Sleep Quality Index (PSQI) was employed in the study which tested 78 migraineurs and 208 non-migraineurs who formed the control group.

The PSQI is a tool in the form of a scoring but subjective questionnaire developed by the Sleep Medicine Institute of the University of Pittsburgh. It has questions within it’s 7 broad components on which a patient is scored, viz;

  • Subjective Sleep Quality,
  • Sleep Latency,
  • Sleep Duration,
  • Habitual Sleep Efficiency,
  • Sleep Disturbance,
  • Use of Sleep Medicines,
  • Daytime Dysfunction.

Todd Smitherman and his team found that sleep quality was significantly worse for those experiencing episodic migraines than for those in the control group. The migraining group scored an average PSQI of 8.90 as compared to 6.63 in the control group. A PSQI score more than 5 is considered significantly bad.

Factors such as depression, anxiety were adjusted for the regression analysis calculations but still it accounted for 5.3% and 5.8% of unique variance in headache frequency and disability, respectively, which the researchers say is a modest but non-trivial amount. Even when depression and anxiety factors after poor sleep quality were included in the calculations the affective symptoms did not significantly improve these analysis models beyond that of sleep quality alone which made sleep quality almost an independent and very relevant factor in assessing headache frequencies and related disabilities.

As per Smitherman, “As such, sleep quality should be assessed preferentially to other sleep disturbance variables when subjective self-report measures of insomnia are used. In light of the present findings, conclusions from systematic reviews, and practice guidelines, the most potent means of improving sleep quality and insomnia among migraineurs is likely a treatment package that incorporates stimulus control and/or sleep restriction in addition to basic sleep hygiene education and management of comorbid psychiatric symptoms.” (2)

SOURCES:

  1. Image Credits: Freedigitalphotos.net; Tired Woman by Graur Codrin; Web August 2013; http://www.freedigitalphotos.net/images/agree-terms.php?id=10021635
  2. Sleep Quality A Key Contributor To Migraine Severity; MedWireNews.com (Springer Healthcare Limited); Web August 2013; http://www.medwirenews.com/44/104664/General_neurology/Sleep_quality_a_key_contributor_to_migraine_severity_.html
  •  Abstract of the research may be had at:

Sleep Disturbance and Affective Comorbidity Among Episodic Migraineurs; Wiley Online Library; Web August 2013; http://onlinelibrary.wiley.com/doi/10.1111/head.12168/abstract

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Co-morbidity of Migraine and Depression In Women

Most of us are aware that migraineurs have some comorbid conditions like generalised anxiety disorder, cardiovascular conditions and gastrointestinal disturbances. Research now has it that migraineurs especially women who have either experienced repeated episodes of migraines in the past or continue to have migraines are more likely to experience depression.

Women Migraineurs Very Likely To Develop Depression (1)

In fact another report goes on to suggest that the most ‘important’ comorbidity of migraines is depression with as many as 40% of all migraineurs also suffer from forms of depression. (2)

New research released on 23rd of February which was presented at the American Academy of Neurology’s 64th Annual Meeting showed that migraining women specifically had a higher risk of almost double for developing depression than those women who did not experience migraines.

This study had examined the medical history of 36,154 women participants. The whole population studied were classified into 4 groups:

  • Women with migraines and experiencing aura
  • Women with migraines who do not experience aura
  • Women who had suffered migraines in the past but have not in the last one year
  • Women who never had migraines

It was observed after collection and analysis of data that as many as 18% of the studied population had either current or past history of migraines and that of this group of 6, 456 women almost half of them developed depression 14 years on.

Another observation of note was that the results in terms of the probability of developing depression for women migraineurs remains almost same regardless of the type of migraines they experience (i.e. with or without visual aura)

The results did not vary substantially, regardless of the type of migraine. Those with aura, which is described as visual disturbances that appear as flashing lights, zigzag lines or a temporary loss of vision, had the same risks as other types of migraine.

According to Tobias Kurth, MD, ScD, with Brigham and Women’s Hospital in Boston and Inserm in France and a Fellow of the American Academy of Neurology, “This is one of the first large studies to examine the association between migraine and the development of depression over time. We hope our findings will encourage doctors to speak to their migraine patients about the risk of depression and potential ways to prevent depression.” (3)

This is a cue to doctors and headache specialists who treat migraineurs for assessing the patient for possible symptoms of depression and chalking out an appropriate management program for them.

SOURCES:

  1. Image by David Castillo Dominici; Freedigitalphotos.net; February 2012; http://www.freedigitalphotos.net/images/view_photog.php?photogid=3062
  2. Comorbidities of Migraine – Page 4; Lisa K Mannix, MD; February 2012; http://www.headaches.org/pdf/CME_Mono02.pdf
  3. Migraine Increases Risk Of Depression In Women; Medical News Today; February 2012; http://www.medicalnewstoday.com/articles/242091.php

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