The Characteristics of Sleep in Headache Patients

Abstract

Purpose: To investigate the relationship between headache and sleep by evaluating sleep quality, daytime sleepiness, and specific features related to sleep-disordered breathing (SDB).

Methods: One hundred one subjects with headache and 118 healthy controls were enrolled. To collect various information on headache attacks, headache group completed self-reported questionnaire about the characteristics of headache attacks and the migraine disability assessment (MIDAS) questionnaire. The subjective quality of sleep was evaluated in all of the subjects using the Pittsburgh sleep quality index (PSQI) and Epworth sleepiness scale (ESS). In addition, the following specific features of sleep were evaluated in 28 subjects selected randomly from each group: apnea-hypopnea index (AHI), prevalence of SDB, nocturnal oxygen saturation (SaO₂), and oxygen desaturation index (ODI) as measured using a portable monitoring device.

Results: The global PSQI and the prevalence of poor sleeping (global PSQI ＞5), ESS scores and the prevalence of daytime sleepiness (ESS score ＞10) were significantly higher in the headache group (both p＜0.0001, respectively). The mean scores on the numerical rating scale and the MIDAS were significantly higher in the poor-sleeper group than in the good-sleeper group (p=0.0347 and p=0.0016, respectively). The global PQSI and prevalence of daytime sleepiness were significantly higher in the chronic-headache group than in the acute-headache group (p=0.0003 and p=0.0312, respectively).

Conclusions: There is a significant association between headache and sleep. Especially, severity and chronicity of headache were significantly associated with sleep quality and daytime sleepiness.