Poor sleep increases migraine pain and mental health burden – Physician’s Weekly

For migraine patients, poor sleep quality contributes to increased migraine risk and migraine pain, as well as reduced quality of life and mental health.

Migraine has been shown to significantly reduce HRQoL and have substantial effects on daily activities, direct medical costs, and prevalence of comorbidities. Early detection of factors strongly associated with migraine is essential for reducing disease burden, with important implications for prevention, treatment and prognosis.

Studies have also shown that migraine is associated with a wide range of sleep disorders. “Poor sleep quality is one of the most common sleep disorders in migraine patients and can impact the chronicity of migraine,” says Zunjing Liu. However, data on associations between sleep quality and the risk of developing migraine have not been fully elucidated in clinical research.

The Pittsburgh Sleep Quality Index (PSQI) is a self-reported sleep quality questionnaire that assesses sleep quality over the past month and can be used to assess poor sleep quality in patients with migraine. Given the previously documented relationships between sleep and migraine in published research, the PSQI score may be useful as a predictor of migraine. However, few analyzes have reported the predictive value of the PSQI score for migraine.

For a study published in Frontiers in Neurology, Liu and colleagues systematically explored the relationship between sleep quality and the risk of developing migraine; they also looked at gender and age differences. They investigated associations between sleep quality and total pain burden, severity, disability, headache impact, quality of life, anxiety and depression. Sleep quality was assessed using the PSQI. A total of 134 migraine patients and 70 sex- and age-matched healthy controls were included in the analysis.

Poor sleep more common in migraine patients

According to the results, the prevalence of poor sleep quality in patients with migraine was significantly higher than in those without headache. “About two-thirds of migraine patients had poor sleep quality, and poor sleep quality was significantly associated with an increased risk of migraine,” Liu says.

After adjusting for different confounders, the risk of developing migraine in people with poor sleep quality was still 3.981 times higher than in patients with good sleep quality. Additionally, the authors noted that PSQI scores had good diagnostic specificity for migraine.

In a subgroup analysis, the researchers observed significant additive interactions between poor sleep quality and migraine risk based on gender, age, and education level. Stronger correlations were found in women, patients aged 35 and over, and in those with a lower level of education (Table). Additionally, multivariate linear regression analysis showed that poor sleep quality was significantly and independently associated with total pain burden, headache severity, impact, quality of life, anxiety and depression in patients with migraine.

Integrating sleep quality into the treatment of migraine

Associations between sleep quality and migraine-related burdens are important topics that deserve more attention, according to Liu. The current study showed that poor sleep quality was significantly and independently associated with a higher risk of developing migraines and migraine-related burdens. This information can be used to develop new interventions aimed at improving the prevention and treatment of migraine-related burdens, according to Liu and colleagues.

The authors also recommend using PSQI ratings when evaluating patients with migraine.

“The PSQI tool is convenient, practical and accurate for assessing sleep quality,” says Liu. “It may also guide early prevention efforts and sleep interventions when caring for patients with migraine.”

Since the PSQI score had good predictive accuracy and diagnostic specificity for migraine, it may be a potential predictor of migraine, but this requires further validation in future research.

The study team hopes to expand the sample size in future research to explore the effect of preventive treatment on associations between sleep quality and migraine. Studies are also needed to determine whether associations between sleep quality and migraine are different depending on whether or not patients receive migraine preventive treatments.