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Sleep complaints linked to chronic headaches
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Patients presenting with sleep issues are more likely to have chronic headaches, according to findings presented at the American Academy of Neurology Annual Meeting.
“The relationship of sleep and headaches is considered bidirectional — pain can cause sleep disruption and sleep disruption not only worsens pain, but severe lack of sleep has been linked to mood disorders, depression, anxiety and even Alzheimer’s disease,” Natalia Murinova, MD, MPH, clinical associate professor of neurology at the University of Washington and director of its Medicine Headache Center, told Healio Family Medicine.
To help determine the connection between and frequency of sleep problems and specific headache diagnoses, researchers utilized detailed intake questionnaires completed by 1,721 patients prior to their first visit to a tertiary headache clinic. When responding to items in the questionnaire such as “Do you have any problems that interfere with getting good sleep?” patients could specify insomnia, trouble falling asleep, trouble staying asleep, waking up not feeling refreshed, frequent awakening, sleep apnea, narcolepsy, hypersomnia or other. Multiple sleep complaints could be indicated, according to the study.
Murinova and colleagues found that 67.2% (n = 1,156) of the study population experienced some type of difficulty with sleep. According to the study, 63.8% (n = 725) of patients reported waking up not feeling refreshed, 61.4% (n = 698) had trouble staying asleep and 57.3% (n = 652) had trouble falling asleep. Additionally, 53.2% (n = 605) reported frequent awakening, 33.7% (n = 383) reported insomnia and 14.3% (n = 163) had sleep apnea.
“In headache patients, sleep deprivation is one of the triggers for migraines and problems with sleep are likely contributing to migraine chronification,” Murinova said in the interview.
Of patients who have headaches, individuals who reported sleep problems were more likely to experience chronic headaches and medication overuse headaches than individuals who did not have sleep complaints. According to the study, chronic migraines afflicted 71.9% of patients with headaches and sleep complaints vs. the 52.3% of patients with headaches and no sleep complaints. Similarly, 55.4% of patients with headaches and sleep complaints and 42.3% of patients with headaches and no sleep complaints experienced medication overuse headaches.
The study suggests that specialty headache care should include sleep assessment and treatment and researchers recommend a more vigilant attitude concerning sleep comorbidities associated with headaches.
“It is important to research sleep in patients with headaches because sleep disorder is likely a potential modifiable risk factor for migraine progression,” Murinova said in the interview. “We still have no definitive explanation why we need sleep, but it is likely that only during sleep we are ‘offline’ and this helps us ‘unplug’ and assimilate all the day’s input of information.” – by Marley Ghizzone
Reference: Murinova N, et al. Sleepy brain in pain; Prevalence of sleep problems in a university-based headache clinic. Presented at: American Academy of Neurology Annual Meeting; April 21-27, 2018; Los Angeles.
Disclosure: Healio Family Medicine could not confirm relevant financial disclosures at the time of publication.