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July 25, 2022
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Study shows people with migraines have lower risk for sleep apnea

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CHARLOTTE, N.C. — Study participants with a history of migraine experienced less sleep apnea and hypoxia than those without migraine, according to a poster presented at the SLEEP meeting.

“Disruption in sleep may serve as a risk for migraine or result from migraine,” Eric C. Gruenthal, MD, a neurologist at the Cleveland Clinic, and colleagues wrote in their poster. “We leveraged a large clinical cohort to examine the hypothesis that those with migraine have greater degrees of sleep architectural alterations and sleep disordered breathing.”

Migraine

Gruenthal told Healio in an interview that all sleep study patients between 1998 and 2021 were included in this retrospective case-control study. A total of 98,084 patients met the inclusion criteria, and 4,783 with a history of migraine were matched to controls.

The study abstract specified that participants, all older than 18 years, were matched 1:3 on age, sex, race, BMI and year of polysomnogram (PSG). Researchers observed sleep architecture, which included arousal index (AI), total sleep time (TST) and percentage of sleep stage time; sleep disordered breathing (SDB); apnea hypopnea index (AHI); and mean oxygen saturation.

“Did migraine cases have any PSG findings relative to sleep architecture and sleep disordered breathing?” Gruenthal asked.

“AHI was significantly lower in migraine,” he said. “Percentage of sleep time was significantly lower. Arousal index was significantly lower.”

The study results specified AHI as 7.4 (95% CI, 2.6-17) in those with migraine vs. 9.5 (95% CI, 3.7-22.1) in those without; TST as 359 minutes (95% CI, 307-421) in those with migraine vs. 363 minutes (95% CI, 306-432.5) in those without; and AI as 19.6 (95% CI, 12.8-30.9) in those with migraine vs. 22.6 (95% CI, 14.7-34.9) in those without.

In addition, mean oxygen saturation was higher (93.7% ± 2.4 vs. 93.3 ± 2.6, P < 0.001), and percentage of REM was lower (16.7%, 95% CI, 10-22) vs. 17.0% (95% CI, 11.1-22.2).

Gruenthal concluded: “Overall results suggest migraine patients may be less at risk for sleep apnea than non-migraine patients. We don’t know why. We theorize it has to do with calcitonin gene-related peptide (CPRG), which is elevated in migraine patients. CPRG is highly involved in brain signaling. We theorize that because of CPRG and serotonin, physiology may be protected against sleep disorders.”