Sleep Disorders Among People With Migraine: Results From the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study

Abstract

Objectives.— We examined the cross-sectional association of sleep apnea and indices of sleep quality with both episodic migraine (EM) and chronic migraine (CM). Background.— Sleep apnea and abnormal patterns of sleep, such as insomnia, were associated with migraine onset, severity, and progression in previous research. Methods.— The Chronic Migraine Epidemiology & Outcomes Study, a longitudinal study, used a series of web-based surveys to assess migraine symptoms, burden, and patterns of health care utilization. Quota sampling was used from September 2012 to November 2013 to generate a representative sample of the US population. Persons who screened positive for sleep apnea on the Berlin Questionnaire are said to be at “high risk” for sleep apnea. Respondents indicated if they believed that they had sleep apnea, if a physician had diagnosed it, and if and how they were treated. Other aspects of sleep quality were assessed using the Medical Outcomes Study (MOS) Sleep Measures. Results.— Of 12,810 eligible respondents with migraine and data on sleep, 11,699 with EM (91.3%) and 1111 with CM (8.7%) provided valid data for this analyses. According to the Berlin Questionnaire, 4739/12,810 (37.0%) were at “high risk” for sleep apnea, particularly persons with CM vs EM (575/1111 [51.8%] vs 4164/11,699 [35.6%]), men vs women (1431/3220 [44.4%] vs 3308/9590 [34.5%]), people with higher body mass index, and older people (all P < .001). Among respondents to the MOS Sleep Measures, persons with CM were more likely to report poor sleep quality than those with EM, including sleep disturbance (mean [SD] values: 53.2 [26.9] vs 37.9 [24.3]), snoring (38.0 [33.9] vs 31.0 [32.1]), shortness of breath (34.9 [29.8] vs 15.3 [20.6]), somnolence (44.1 [23.4] vs 32.2 [21.2]), and less likely to report sleep adequacy (34.0 [24.2] vs 39.2 [22.1]). Conclusions.— Compared with respondents with EM, a larger proportion of those with CM were at “high risk” for sleep apnea and reported poor sleep quality. This reflects an association between CM vs EM and sleep apnea and poor sleep quality; the potential relationships are discussed.

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

“…Many medical conditions are more common in people with migraine compared to the general population [33]. There is a small body of literature examining rates of single medical conditions among people with and without migraine, and over the past decade, a growing body of literature has emerged examining the effect of headache day frequency on rates of migraine comorbidities and the effects of selected comorbidities on headache progression [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][22][23][24][25][26][27][28]. After adjusting for sociodemographic variables, the cohort with migraine was about three times more likely to report a medical diagnosis of insomnia, depression, anxiety, and gastric ulcer/GI bleeding.…”

“…Comorbidity is the greater than chance association between the two conditions in the same individual [2]. There are many comorbidities associated with migraine including cardiovascular disorders (i.e., stroke, myocardial infarction [3][4][5][6][7][8][9][10], psychiatric disorders (i.e., depression, anxiety, panic disorder, bipolar disorder, personality disorders, suicide attempts) [11][12][13][14][15][16][17][18][19][20][21], neurologic diseases (i.e., epilepsy), sleep conditions (i.e., insomnia, restless leg syndrome, sleep apnea, poor sleep quality and duration) [22][23][24], inflammatory conditions (i.e., allergic rhinitis, asthma) [25,26] as well as chronic pain conditions (i.e., fibromyalgia) [27], among many others [28]. Many comorbidities have been identified as risk factors for progression to chronic migraine [29] and recent work has shown that the combination of comorbidities or "multimorbidity" is associated with medication overuse and new onset CM [30,31].…”

United States Patients’ Perspective of Living With Migraine: Country‐Specific Results From the Global “My Migraine Voice” Survey

“…‡The survey asked respondents to report fear of next migraine attack on a 1 to 5 scale, where 1 = not fearful at all, 2 = a little fearful, 3 = somewhat fearful, 4 = very fearful, and 5 = extremely fearful. 19 and that people with migraine worry about a next migraine attack, 20 experience low sleep quality, 21,22 and rely on family for help. 23,24 Our study is unique in that it also provides this data by respondents' preventive treatment history.…”

Morning Headache as an Obstructive Sleep Apnea-Related Symptom among Sleep Clinic Patients—A Cross-Section Analysis

“…However, the exact cause of this type of headache still remains unclear [6,7]. The most extensively studied epidemiological association in OSAS patients was between headaches and snoring [10,11]. MH is not specific and may complicate many other diseases such as anxiety and depression, circadian rhythm disorders, unspecified dyssomnia, and last but not least, arterial hypertension [11][12][13].…”