Poor sleep quality in patients affected by migraine: a population study
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Poor sleep quality in patients affected by migraine: a population study Giovanna Viticchi 1 & Claudia Altamura 2 & Lorenzo Falsetti 3 & Laura Buratti 1 & Sergio Salvemini 1 & Federica Polidoro 1 & Mauro Silvestrini 1 & Fabrizio Vernieri 2 & Marco Bartolini 1
# Fondazione Società Italiana di Neurologia 2020
Recent evidences suggest that sleep quality can influence migraine severity. The physiopathological bases for this relationship are not completely understood. Several sleep alterations are correlated with headache occurrence, in particular insomnia, OSAS, bruxism, or restless legs syndrome that are associated with REM sleep disorders. Hypothalamus could play a pivotal role being both the center of the “flip-flop switch,” responsible for the alternance between sleep and wakefulness, and the primary mediator in the migraine attacks. Furthermore, several neurotransmitters and hormones seem to play a role in the association between migraine and sleep disturbances. GABA, serotonin, dopamine, and gonadotropin-releasing hormone changes have been evidenced in both migraine and sleep disorders [1]. On the other hand, sleep-inducing drugs or migraine attacks prophylaxis can influence the circadian rhythm. Aim of this study was to evaluate the presence of possible alterations in sleep quality and their relationship with disease severity in a population of patients affected by migraine without any previous specific therapy for headache or sleep disturbances. We evaluated all the patients consecutively observed in two Headache Centers, the Headache Center of Ospedali Riuniti Ancona and the Headache Unit of Campus Bio-Medico University of Rome, during a six-
* Giovanna Viticchi [email protected] 1
Neurologic Clinic, Marche Polytechnic University, Via Conca 1, 60020 Ancona, Italy
2
Neurology Department, Headache and Neurosonology Unit, Campus Bio-Medico University of Rome, Rome, Italy
3
Internal and Subintensive Medicine, Ospedali Riuniti Ancona, Ancona, Italy
month period. The inclusion criteria were as follows: (a) a first diagnosis of migraine with or without aura; (b) no previous prophylactic therapy for headache; (c) no sleepinducing drugs use at the moment of the migraine diagnosis. The diagnosis of migraine was performed according to IHS 2018 criteria. We submitted each patient to the Pittsburgh Sleep Quality Index (PSQI) in order to obtain a sleep quality evaluation and to the Migraine Disability Assessment (MIDAS) questionnaire to evaluate the impact of headache on the quality of life. Age, years of pathology, number of migraine attacks in the last month, number of migraine attacks in the last three months, and Pittsburg and MIDAS scores were treated as continuous variables and tested for normality with Kolomogorov-Smirnov test. Normally distributed variables were presented as mean and standard deviation (SD) and compared with t test. Non-normally distributed variables were synthesized as median and interquartile range (IQR) and compared with Mann-Whitney U test. Sex and type of migrain
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