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Insomnia and circadian variation of attacks in episodic migraine.
Headache. 2007 Sep; 47(8):1184-8.H

Abstract

OBJECTIVES

To assess the influence of insomnia on the 24-hour temporal pattern of migraine.

BACKGROUND

Migraine attacks have been reported to occur in a harmonic (monophasic) or a biphasic 24-hour cyclic manner, and in some studies to have preponderance in the morning hours. The influence of insomnia on the circadian pattern has not been evaluated.

METHOD

Based on a previous study of the circadian variation in migraine, an explorative data analysis was made to compare the circadian pattern of insomnia-related migraine attacks to the circadian pattern of migraine attacks not related to insomnia. If the patients reported difficulties in falling asleep and/or maintaining sleep the night prior to the reported attack or the night the attack occurred, the attack was defined as insomnia-related. Relapses were not counted as distinctive attacks.

RESULTS

Sixty-eight female migraineurs (mean +/- SD age: 35.5 +/- 7.0) prospectively recorded 1869 migraine attacks. Five hundred-and-thirty-three attacks (29%) were insomnia-related. Insomnia-related attacks had a biphasic temporal pattern with one peak in the morning hours and one peak after noon. They had a preponderance in the morning hours compared to attacks not related to insomnia (t= 3.27, df = 62, P= .002). In 79% of attacks insomnia was experienced prior to the headache.

CONCLUSIONS

Episodic morning migraine is associated with insomnia. The cause and consequences of insomnia in migraine is not clarified, but sleep obviously protects against attacks rather than provokes them.

Authors+Show Affiliations

Department of Neurology, Nordlandssykehuset, Bodø, Norway.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17883523

Citation

Alstadhaug, Karl, et al. "Insomnia and Circadian Variation of Attacks in Episodic Migraine." Headache, vol. 47, no. 8, 2007, pp. 1184-8.
Alstadhaug K, Salvesen R, Bekkelund S. Insomnia and circadian variation of attacks in episodic migraine. Headache. 2007;47(8):1184-8.
Alstadhaug, K., Salvesen, R., & Bekkelund, S. (2007). Insomnia and circadian variation of attacks in episodic migraine. Headache, 47(8), 1184-8.
Alstadhaug K, Salvesen R, Bekkelund S. Insomnia and Circadian Variation of Attacks in Episodic Migraine. Headache. 2007;47(8):1184-8. PubMed PMID: 17883523.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Insomnia and circadian variation of attacks in episodic migraine. AU - Alstadhaug,Karl, AU - Salvesen,Rolf, AU - Bekkelund,Svein, PY - 2007/9/22/pubmed PY - 2008/1/9/medline PY - 2007/9/22/entrez SP - 1184 EP - 8 JF - Headache JO - Headache VL - 47 IS - 8 N2 - OBJECTIVES: To assess the influence of insomnia on the 24-hour temporal pattern of migraine. BACKGROUND: Migraine attacks have been reported to occur in a harmonic (monophasic) or a biphasic 24-hour cyclic manner, and in some studies to have preponderance in the morning hours. The influence of insomnia on the circadian pattern has not been evaluated. METHOD: Based on a previous study of the circadian variation in migraine, an explorative data analysis was made to compare the circadian pattern of insomnia-related migraine attacks to the circadian pattern of migraine attacks not related to insomnia. If the patients reported difficulties in falling asleep and/or maintaining sleep the night prior to the reported attack or the night the attack occurred, the attack was defined as insomnia-related. Relapses were not counted as distinctive attacks. RESULTS: Sixty-eight female migraineurs (mean +/- SD age: 35.5 +/- 7.0) prospectively recorded 1869 migraine attacks. Five hundred-and-thirty-three attacks (29%) were insomnia-related. Insomnia-related attacks had a biphasic temporal pattern with one peak in the morning hours and one peak after noon. They had a preponderance in the morning hours compared to attacks not related to insomnia (t= 3.27, df = 62, P= .002). In 79% of attacks insomnia was experienced prior to the headache. CONCLUSIONS: Episodic morning migraine is associated with insomnia. The cause and consequences of insomnia in migraine is not clarified, but sleep obviously protects against attacks rather than provokes them. SN - 0017-8748 UR - https://www.unboundmedicine.com/medline/citation/17883523/Insomnia_and_circadian_variation_of_attacks_in_episodic_migraine_ L2 - https://doi.org/10.1111/j.1526-4610.2007.00858.x DB - PRIME DP - Unbound Medicine ER -