Migraine leads to increased risk, underdiagnosis of sleep disorders

Dawn C. Buse

The risk for sleep apnea and sleep disturbances is higher among those with migraine, according to data from the Chronic Migraine Epidemiology and Outcomes (CaMEO) study, presented at the American Academy of Neurology Annual Meeting.

“Results from the CaMEO Study suggest that persons with migraine and especially those with chronic migraine have a ‘high risk’ of sleep apnea and multiple indices of poor sleep quality and adequacy,” Dawn C. Buse, PhD, clinical professor in the department of neurology at Albert Einstein College of Medicine and assistant professor of clinical health psychology doctoral program at Ferkauf Graduate School of Psychology of Yeshiva University, told Healio Internal Medicine. “The high risk of sleep apnea and breathing-related sleep problems was particularly high among men, those with chronic migraine, higher BMI, and older age. Reports of sleep disturbances, low quality and inadequacy were high across both genders.”

To assess the relationship of sleep disturbances and sleep apnea as comorbidities of episodic and chronic migraine, researchers conducted a cross-sectional analysis wherein participants (n = 12,810) completed baseline and 3-month follow-up surveys over 1 year. To evaluate the risk of sleep apnea, researchers used a comorbidities/endophenotypes survey, which is based on the Berlin Scale for Sleep Apnea. Participants were also asked to report whether they had a physician’s diagnosis of the condition. Researchers measured sleep disturbances through use of the Medical Outcomes Study Sleep Scale.

Results showed that 37% of participants were at high risk for sleep apnea (P < .001), with 10.1% of participants self-reporting a sleep apnea diagnosis. Of those who self-reported a diagnosis, 75.7% reported a physician’s diagnosis. Participants also reported snoring (32.1% of those with episodic migraine; 33.9% with chronic migraine), shortness of breath (episodic migraine: 20.6%; chronic migraine: 29.8%), daytime somnolence (episodic migraine: 21.2%; chronic migraine: 23.4%), and sleep inadequacy (episodic migraine: 22.1%; chronic migraine: 24.2%).

“These results suggest that assessing sleep quality and screening for sleep apnea is valuable for patients with migraine, especially among men and people with chronic migraine, older age, and higher BMI,” Buse said. “People with migraine who screen positive for sleep apnea should be referred for additional evaluation and treatment. All people with migraine should be educated about proper sleep hygiene practices and the benefits of proper sleep hygiene, maintaining a regular sleep schedule and getting adequate hours of sleep for migraine management.”– by Melissa J. Webb

Reference:

Buse DC, et al. The relationship between sleep disorders and migraine: Results from the chronic migraine epidemiology and outcomes (CaMEO) study. Presented at: American Academy of Neurology Annual Meeting; April 21-27, 2018; Los Angeles, CA.

Disclosures: The study was funded by Allergan plc. The authors report no other relevant financial disclosures.