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Behavioral sleep modification may revert transformed migraine to episodic migraine.
Headache. 2007 Sep; 47(8):1178-83.H

Abstract

BACKGROUND

Sleep problems have been linked with headaches for more than a century, but whether the headaches are the cause or the result of the disrupted sleep is unknown.

OBJECTIVES

We previously reported that nonrestorative sleep and poor sleep habits are almost universal in a referral population of women with transformed migraine (TM). Since cognitive behavioral therapy is effective in improving sleep quality in individuals with poor sleep hygiene, we designed a randomized, placebo-controlled study to assess the impact of such treatment on TM. We hypothesized that behavioral sleep modification (BSM) would be associated with improvement in headache frequency and intensity and with reversion to episodic migraine.

METHODS

Subjects were 43 women with TM referred to an academic headache center. After obtaining informed consent, patients were randomized to receive either behavioral sleep instructions or placebo behavioral instructions in addition to usual medical care. Subjects recorded headaches in standardized diaries. The first postintervention visit was scheduled at 6 weeks. At that visit, the blind was broken and all subjects received BSM instructions. A final visit was scheduled 6 weeks later.

RESULTS

Compared to the placebo behavioral group, the BSM group reported statistically significant reduction in headache frequency [F (1, 33 = 12.42, P=.001)] and headache intensity [F(1, 33 = 14.39, P= .01)]. They were more likely to revert to episodic migraine chi2 (2, n = 43) = 7.06, P= .029. No member of the control group reverted to episodic migraine by the first postintervention visit. By the final visit, 48.5% of those who had received BSM instructions had reverted to episodic migraine.

CONCLUSIONS

In this pilot study of women with TM, we found that a targeted behavioral sleep invention was associated with improvement in headache frequency, headache index, and with reversion to episodic migraine.

Authors+Show Affiliations

Department of Neurology, University of North Carolina, Chapel Hill, NC 27599, USA.No affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17883522

Citation

Calhoun, Anne H., and Sutapa Ford. "Behavioral Sleep Modification May Revert Transformed Migraine to Episodic Migraine." Headache, vol. 47, no. 8, 2007, pp. 1178-83.
Calhoun AH, Ford S. Behavioral sleep modification may revert transformed migraine to episodic migraine. Headache. 2007;47(8):1178-83.
Calhoun, A. H., & Ford, S. (2007). Behavioral sleep modification may revert transformed migraine to episodic migraine. Headache, 47(8), 1178-83.
Calhoun AH, Ford S. Behavioral Sleep Modification May Revert Transformed Migraine to Episodic Migraine. Headache. 2007;47(8):1178-83. PubMed PMID: 17883522.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Behavioral sleep modification may revert transformed migraine to episodic migraine. AU - Calhoun,Anne H, AU - Ford,Sutapa, PY - 2007/9/22/pubmed PY - 2008/1/9/medline PY - 2007/9/22/entrez SP - 1178 EP - 83 JF - Headache JO - Headache VL - 47 IS - 8 N2 - BACKGROUND: Sleep problems have been linked with headaches for more than a century, but whether the headaches are the cause or the result of the disrupted sleep is unknown. OBJECTIVES: We previously reported that nonrestorative sleep and poor sleep habits are almost universal in a referral population of women with transformed migraine (TM). Since cognitive behavioral therapy is effective in improving sleep quality in individuals with poor sleep hygiene, we designed a randomized, placebo-controlled study to assess the impact of such treatment on TM. We hypothesized that behavioral sleep modification (BSM) would be associated with improvement in headache frequency and intensity and with reversion to episodic migraine. METHODS: Subjects were 43 women with TM referred to an academic headache center. After obtaining informed consent, patients were randomized to receive either behavioral sleep instructions or placebo behavioral instructions in addition to usual medical care. Subjects recorded headaches in standardized diaries. The first postintervention visit was scheduled at 6 weeks. At that visit, the blind was broken and all subjects received BSM instructions. A final visit was scheduled 6 weeks later. RESULTS: Compared to the placebo behavioral group, the BSM group reported statistically significant reduction in headache frequency [F (1, 33 = 12.42, P=.001)] and headache intensity [F(1, 33 = 14.39, P= .01)]. They were more likely to revert to episodic migraine chi2 (2, n = 43) = 7.06, P= .029. No member of the control group reverted to episodic migraine by the first postintervention visit. By the final visit, 48.5% of those who had received BSM instructions had reverted to episodic migraine. CONCLUSIONS: In this pilot study of women with TM, we found that a targeted behavioral sleep invention was associated with improvement in headache frequency, headache index, and with reversion to episodic migraine. SN - 0017-8748 UR - https://www.unboundmedicine.com/medline/citation/17883522/Behavioral_sleep_modification_may_revert_transformed_migraine_to_episodic_migraine_ DB - PRIME DP - Unbound Medicine ER -