Nightly sleep duration, fragmentation, and quality and daily risk of migraine

Bertisch, Suzanne M.; Li, Wenyuan; Buettner, Catherine; Mostofsky, Elizabeth; Rueschman, Michael; Kaplan, Elina; Fung, Jacqueline; Huntington, Shaelah; Murphy, Tess; Stead, Courtney; Burstein, Rami; Redline, Susan; Mittleman, Murray A.

doi:10.1212/wnl.0000000000008740

Cited by 39 publications

(43 citation statements)

References 36 publications

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“…In unpublished sensitivity analyses restricted to participants reporting short or long sleep as a trigger, the results were similar. 2 We acknowledge that our current analyses do not answer the question raised by Dr. Cooper and Dr. Kaniecki as to whether sleep regularity, which may reflect circadian phase and represents an orthogonal dimension of sleep, 3 is associated with migraine. We agree that this is an important area of future investigation.…”

Section: Comments Observations and Rebuttals The Sleep -Migraine Enmentioning

confidence: 72%

“…While more work is needed, our recent studies emphasize the importance of identifying and targeting sleep problems in patients with episodic migraine. 2,4 Clinicians should avoid attributing migraine attacks solely to sleep problems. Likewise, we should not attribute sleep problems solely to the occurrence of individual attacks.…”

Section: Comments Observations and Rebuttals The Sleep -Migraine Enmentioning

confidence: 99%

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The Sleep – Migraine Enigma: A Comment

Vgontzas

Mostofsky

et al. 2020

Headache

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Section: Comments Observations and Rebuttals The Sleep -Migraine Enmentioning

confidence: 72%

Section: Comments Observations and Rebuttals The Sleep -Migraine Enmentioning

confidence: 99%

The Sleep – Migraine Enigma: A Comment

Vgontzas

Mostofsky

et al. 2020

Headache

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“…The behaviors adopted to cope with migraine attacks (napping, oversleeping, caffeine, and medication intake) are known to reduce the likelihood of rapid sleep onset at night, reduce sleep homeostasis, and disrupt circadian rhythms . These changes in turn can lead to an increased propensity to future headache attacks . This increased propensity leads to further engagement in coping behaviors, which triggers a vicious cycle between headache attacks and chronic insomnia.…”

Section: Introductionmentioning

confidence: 99%

Digital Cognitive Behavioral Therapy for Insomnia in Women With Chronic Migraines

et al. 2020

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Objective/Background.-Insomnia commonly co-occurs with chronic migraines (CM). Non-pharmacological treatments for insomnia in CM patients remain understudied. This is a proof-of-concept study, which aims to evaluate the feasibility, acceptability, and preliminary efficacy of a digital cognitive behavioral therapy for insomnia (dCBT-I) for individuals with CM and insomnia (CM-I) in the United States.Methods.-We recruited 42 females with CM-I symptoms from a U.S.-based observational cohort and from the general population via advertisements. Within a multiple baseline design, participants were randomized to receive dCBT-I after 2, 4, or 6 weeks of completing baseline sleep diaries. DCBT-I was scrutinized against benchmarks for completion rates (≥90% to complete dCBT-I), acceptability (≥80% to find dCBT-I acceptable), and posttreatment changes in insomnia symptoms (≥50% indicating a clinically relevant improvement in their insomnia symptoms). As a secondary measure, we also reported percentage of individuals reverting to episodic migraines. Results.-Out of 42 randomized, 35 (83.3%) completed dCBT-I within the 12 weeks provided. Of these completers, 33 (94.3%) reported being satisfied (n = 16) or very satisfied (n = 17) with treatment. Additionally, 65.7% of completers responded to treatment as per universally accepted criteria for insomnia. Lastly, 34% of completers reverted from CM to episodic migraine. Conclusion.-This study provides evidence for the feasibility and acceptability of dCBT-I in patients with CM-I complaints. Effects of improving insomnia and migraines were suggested. These results indicate that a randomized controlled trial is needed to determine the efficacy of dCBT-I in CM patients.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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“…Therefore, we conducted a secondary analysis of data from 94 of 98 patients with EMs who enrolled in a prospective cohort study to investigate the associations between routine moderate‐vigorous exercise at least three times per week reported at baseline, and prospective headache frequency, intensity, and duration. The prospective cohort study was designed to assess the associations between sleep and other health behaviors, and the occurrence and severity of migraine headaches during follow‐up 14,15 …”

Section: Introductionmentioning

confidence: 99%

Prospective cohort study of routine exercise and headache outcomes among adults with episodic migraine

Hagan

Mostofsky

et al. 2020

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Objective To evaluate the association of routine exercise with headache frequency, intensity, and duration among adults with episodic migraine (EM). Background A comprehensive management plan for EM must aim at reducing disability and cost of care; to do so requires optimizing acute and preventive medications, and behavior changes. Prophylactic medication use is associated with adverse events and contraindications with comorbidities. Aerobic exercise is reported to decrease migraine frequency. However, no study has evaluated a potential synergistic relation between regular exercise and preventive medication use among patients with EM. Design and Methods This was a secondary analysis of data from a prospective cohort study of adults with EMs. In that study, adults with EM (using International Classification of Headache Disorders‐3 criteria confirmed by study physicians) were recruited from three academic medical centers in Boston, MA. At baseline, participants provided information on exercise, clinical and demographic characteristics, and lifestyle behaviors. We prospectively collected daily information on headaches and health behavior over at least 6 weeks using electronic questionnaires from 94 participants. We assessed the association between baseline self‐reported moderate‐vigorous exercise at least three times per week, at baseline, and prospectively recorded headache frequency, intensity, and duration. We further assessed whether these associations differed by the prevalent use of prophylactic migraine medication. Results Data from 94 of 98 eligible participants were used in the analysis as 4 participants had missing data on routine exercise frequency or intensity at baseline. On average, patients who reported moderate‐vigorous exercise at least three times per week at enrollment had 1.5 fewer headache days per month (−1.5 headache days/month; 95% confidence interval [CI] −3.1 to 0.1) compared to less exercise; this was not statistically significant (p = 0.066). The association between exercise and headache days per month varied by baseline use of migraine prophylaxis (p‐value of interaction = 0.009). Among those who reported regular use of migraine prophylaxis, a report of moderate‐vigorous exercise at least three times per week was associated with 5.1 fewer headache days (−5.1: 95% CI −8.2 to −2.0; p = 0.001) compared to those who reported lower levels of exercise. However, among those not using migraine prophylaxis, we observed only 0.4 fewer headache days per month (−0.4: 95% CI −2.2 to 1.3; p = 0.636) associated with moderate‐vigorous exercise at least three times/week, a result that was not statistically significant. There was no association of self‐reported moderate‐vigorous exercise at least three times a week with headache intensity or duration. Conclusion In patients with EM, those who reported moderate‐vigorous exercise at least three times per week had fewer headache days per month, though not statistically significant. This association was significantly stronger in those who used prophy...

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Nightly sleep duration, fragmentation, and quality and daily risk of migraine

Cited by 39 publications

References 36 publications

The Sleep – Migraine Enigma: A Comment

The Sleep – Migraine Enigma: A Comment

Digital Cognitive Behavioral Therapy for Insomnia in Women With Chronic Migraines

Prospective cohort study of routine exercise and headache outcomes among adults with episodic migraine

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