People with migraine are significantly more likely to experience sleep problems than those without headaches. They are also more likely to have a later chronotype — meaning a tendency to fall asleep and wake up later and to be most active in the second half of the day. These are the findings of the largest nationwide study of its kind in Poland.
The study was conducted by a team of researchers from Wroclaw Medical University led by neurologist Marta Walischiewska-Prosol. The researchers analyzed data from 5,311 adults, including 1,523 people with migraine, 2,366 with tension-type headaches, and 209 participants with headaches that could not be classified. Another 1,213 participants reported having had no headaches during the previous 12 months.
The results were published in The Journal of Headache and Pain.
The most notable difference between the groups concerned sleep quality. Sleep problems were identified in 64.1% of participants with migraine, compared with 38.7% of people without headaches. Among participants with tension-type headaches, the figure was 45.4%.
Sleep quality was assessed using the Pittsburgh Sleep Quality Index, which takes into account the time needed to fall asleep, sleep duration and efficiency, nighttime awakenings, and a person's daytime functioning.
People with migraine had worse scores across all the parameters studied. The difference remained even after accounting for age, sex, place of residence, education, marital status, and employment status.
Sleep quality was also associated with migraine severity. Among people with migraine, poor sleep was correlated with more frequent attacks, greater limitations in daily life, higher levels of stress and anxiety, and lower life satisfaction. The strongest association was observed between poor sleep quality and reduced quality of life.
The researchers note that the relationship between migraine and sleep is likely bidirectional. Too little or too much sleep may increase susceptibility to pain, while migraine attacks and associated symptoms can make it difficult to fall asleep and cause nighttime awakenings. The hypothalamus and neurotransmitters involved in regulating circadian rhythms and pain perception play a role in both processes.
The researchers also examined participants' chronotypes — their natural preference for certain times of sleep and activity. Among people with migraine, 24.9% had a “morning” chronotype, compared with 39.1% of participants without headaches.
This does not mean that going to bed and getting up late in itself causes migraine. The researchers note that the differences between the groups were relatively small and that the association between chronotype and clinical manifestations of the disease was weak.
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