Impact of Migraines on Sleep Quality

Prevalence of Migraines

Migraines rank as the third most common illness globally, impacting an estimated one billion individuals annually. In the United States alone, migraines lead to the loss of more than 157 million workdays each year. This condition affects people of all ages, including men, women, and children. However, many individuals suffering from migraines do not seek treatment.

Understanding Sleep Quality Measurements

Individuals with migraines frequently experience sleep disturbances. Although researchers have established a link between migraines and sleep problems, there is limited research exploring this connection in depth. The subjective nature of sleep disturbances complicates measurement, as experiences vary from person to person. To address this, doctors developed the Pittsburgh Sleep Quality Index (PSQI), a questionnaire designed to evaluate sleep quality. This tool consists of a series of questions that assess various aspects of sleep, and it also incorporates feedback from patients’ partners, providing a reliable measure of subjective sleep quality.

Polysomnographic Studies as a Measurement Tool

While the PSQI offers valuable insights, a more precise evaluation of sleep disturbances is achieved through polysomnographic (PSG) studies. These sleep studies involve simultaneous recording of multiple parameters related to sleep and wakefulness.

Alternative Measures of Sleep Abnormalities

Though PSG studies are regarded as the gold standard for assessing sleep abnormalities, the Migraine Disability Assessment (MIDAS) serves a different purpose by measuring the impact of migraine pain on daily life. This questionnaire helps doctors understand how migraines hinder normal activities by assessing the number of painful days experienced over the past three months.

Research Findings on Migraines and Sleep

Meta-Analysis Overview

Researchers from King’s College London conducted a meta-analysis to investigate the differences in PSQI and PSG scores between individuals with migraines and those without. They also explored potential correlations between PSQI and MIDAS scores. Their findings were published in the online issue of the journal, Neurology.

Study Results

The analysis included 32 studies with a total of 10,243 participants. The results confirmed that adults suffering from migraines had poorer PSQI scores compared to those without migraines, with individuals experiencing chronic migraines showing even worse scores. Additionally, both adults and children with migraines exhibited reduced REM sleep as determined by PSG studies. Children with migraines were found to have shorter total sleep durations and took longer to fall asleep than their peers.

Lack of Correlation Between PSQI and MIDAS Scores

Interestingly, the researchers did not identify any significant link between PSQI and MIDAS scores.

Future Research Directions

Given the apparent connection between sleep quality and migraines, the authors of the study advocate for incorporating sleep interventions into migraine treatment plans. They also recommend that individuals with migraines avoid medications that may disrupt sleep. The study highlights a need for further investigation into the relationship between REM sleep and migraines. The authors call for additional large-scale research studies that include PSG to enhance the understanding of this connection.

References

1. Migraine Research Foundation. Migraine Facts – Migraine Research Foundation. Published 2015. Accessed September 27, 2021. https://migraineresearchfoundation.org/about-migraine/migraine-facts/
2. Stanyer EC, Creeney H, Nesbitt AD, Robert Holland PR, Hoffmann J. Subjective sleep quality and sleep architecture in patients with migraine: A meta-analysis. Neurology. Published online September 22, 2021:10.1212/WNL.0000000000012701. doi:10.1212/wnl.0000000000012701
3. Shahid A, Wilkinson K, Marcu S, Shapiro CM. Pittsburgh Sleep Quality Index (PSQI). STOP, THAT and one hundred other sleep scales. Published online 2011:279-283. doi:10.1007/978-1-4419-9893-4_67
4. Armon C, Gardner-Johnson K, Roy A, Nowack WJ. Polysomnography: Overview, parameters monitored, staging of sleep. eMedicine. Published online on December 5, 2020. Accessed September 27, 2021. https://emedicine.medscape.com/article/1188764-overview
5. What Is the MIDAS Test? | Migraine.com. Published 2020. Accessed September 27, 2021. https://migraine.com/pro/midas