Sleep and Migraine: Assessment and Treatment of Comorbid Sleep Disorders

Rains, Jeanetta

doi:10.1111/head.13357

Cited by 69 publications

(44 citation statements)

References 82 publications

(125 reference statements)

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“…Results showed that the prevalence of poor sleep quality was significantly higher among those with migraine and probable migraine than among those without headache (47.6% [migraine] 35.4% [probable migraine vs. 21.0% [non-headache], P < 0.001) Interestingly, in this study, those with comorbid migraine and poor sleep quality also had a statistically significant higher prevalence of anxiety and depression and had migraine attacks that were more intense and of longer duration. As a result, a recent algorithm to manage sleep disorders and migraine has been developed which focuses on making sleep management complementary to headache management [64].…”

Section: Psychiatric and Sleep Conditionsmentioning

confidence: 99%

Comorbid and co-occurring conditions in migraine and associated risk of increasing headache pain intensity and headache frequency: results of the migraine in America symptoms and treatment (MAST) study

Buse

Reed²,

Fanning³

et al. 2020

J Headache Pain

156

150

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Background: Migraine has many presumed comorbidities which have rarely been compared between samples with and without migraine. Examining the association between headache pain intensity and monthly headache day (MHD) frequency with migraine comorbidities is novel and adds to our understanding of migraine comorbidity. Methods: The MAST Study is a prospective, web-based survey that identified US population samples of persons with migraine (using modified International Classification of Headache Disorders-3 beta criteria) and without migraine. Eligible migraine participants averaged ≥1 MHDs over the prior 3 months. Comorbidities "confirmed by a healthcare professional diagnosis" were endorsed by respondents from a list of 21 common cardiovascular, neurologic, psychiatric, sleep, respiratory, dermatologic, pain and medical comorbidities. Multivariable binary logistic regression calculated odds ratios (OR) and 95% confidence intervals for each condition between the two groups adjusting for sociodemographics. Modeling within the migraine cohort assessed rates of conditions as a function of headache pain intensity, MHD frequency, and their combination. Results: Analyses included 15,133 people with migraine (73.0% women, 77.7% White, mean age 43 years) and 77, 453 controls (46.4% women, 76.8% White, mean age 52 years). People with migraine were significantly (P < 0.001) more likely to report insomnia (OR 3.79 [3.6, 4.0]), depression (OR 3.18 [3.0, 3.3]), anxiety (OR 3.18 [3.0 3.3]), gastric ulcers/GI bleeding (OR 3.11 [2.8, 3.5]), angina (OR 2.64 [2.4, 3.0]) and epilepsy (OR 2.33 [2.0, 2.8]), among other conditions. Increasing headache pain intensity was associated with comorbidities related to inflammation (psoriasis, allergy), psychiatric disorders (depression, anxiety) and sleep conditions (insomnia). Increasing MHD frequency was associated with increased risk for nearly all conditions and most prominent among those with comorbid gastric ulcers/GI bleeding, diabetes, anxiety, depression, insomnia, asthma and allergies/hay fever.

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Section: Psychiatric and Sleep Conditionsmentioning

confidence: 99%

Comorbid and co-occurring conditions in migraine and associated risk of increasing headache pain intensity and headache frequency: results of the migraine in America symptoms and treatment (MAST) study

Buse

Reed²,

Fanning³

et al. 2020

J Headache Pain

156

150

View full text Add to dashboard Cite

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“…Some diagnoses were in PDNs for migraine patients that were lacking in control networks; sleep disorders (G47) in cluster M1, acne (L70) and rosacea (L71) in cluster M7, and urticaria (L50) in cluster M6. The connection between migraine and sleep disorders has been recognized [35,36]. However, the connection of migraine and rosacea and other skin disorders is only beginning to emerge, and studies have mainly focused on the increase in odds ratio of migraine in patients with rosacea, not the other way around [37,38].…”

Section: Increased Comorbidity Based On Phenotypic Disease Networkmentioning

confidence: 99%

Burden of migraine in Finland: multimorbidity and phenotypic disease networks in occupational healthcare

Korolainen¹,

Tuominen²,

Kurki

et al. 2020

J Headache Pain

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Background: Migraine is a complex neurological disorder with high co-existing morbidity burden. The aim of our study was to examine the overall morbidity and phenotypic diseasome for migraine among people of working age using real world data collected as a part of routine clinical practice. Methods: Electronic medical records (EMR) of patients with migraine (n = 17,623) and age-and gender matched controls (n = 17,623) were included in this retrospective analysis. EMRs were assessed for the prevalence of ICD-10 codes, those with at least two significant phi correlations, and a prevalence >2.5% in migraine patients were included to phenotypic disease networks (PDN) for further analysis. An automatic subnetwork detection algorithm was applied in order to cluster the diagnoses within the PDNs. The diagnosis-wise connectivity based on the PDNs was compared between migraine patients and controls to assess differences in morbidity patterns. Results: The mean number of diagnoses per patient was increased 1.7-fold in migraine compared to controls. Altogether 1337 different ICD-10 codes were detected in EMRs of migraine patients. Monodiagnosis was present in 1% and 13%, and the median number of diagnoses was 12 and 6 in migraine patients and controls. The number of significant phi-correlations was 2.3-fold increased, and cluster analysis showed more clusters in those with migraine vs. controls (9 vs. 6). For migraine, the PDN was larger and denser and exhibited one large cluster containing fatigue, respiratory, sympathetic nervous system, gastrointestinal, infection, mental and mood disorder diagnoses. Migraine patients were more likely affected by multiple conditions compared to controls, even if no notable differences in morbidity patterns were identified through connectivity measures. Frequencies of ICD-10 codes on a three character and block level were increased across the whole diagnostic spectrum in migraine. Conclusions: Migraine was associated with an increased multimorbidity, evidenced by multiple different approaches in the study. A systematic increase in the morbidity across the whole spectrum of ICD-10 coded diagnoses, and when interpreting PDNs, were detected in migraine patients. However, no specific diagnoses explained the morbidity. The results reflect clinical praxis, but also undoubtedly, the pathophysiological phenotypes related to migraine, and emphasize the importance of better understanding migraine-related morbidity.

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“…Several studies revealed circadian periodicity of migraine attack onset (van Oosterhout et al, 2018), but the underlying mechanism is not understood yet (Gori et al, 2012). Sleeping problems are also regular among migraineurs (Rains, 2018). Melatonin also might have a role in the pathophysiology of migraine, for example through the hypothalamic output of melatonin cycle influencing the trigeminal nucleus caudalis, a known component of migraine pathophysiology (Vogler et al, 2006).…”

Section: Introductionmentioning

confidence: 99%