Poor sleep increases the burden of migraine-related pain and mental health

For migraine patients, poor sleep quality contributes to migraine risk and migraine pain, as well as reduced QoL and mental health.


Migraine has been shown to significantly reduce HRQoL and has a substantial impact on daily activities, direct medical costs and prevalence of co-morbidities. Early detection of factors strongly associated with migraine is critical to reducing the burden of disease, with important implications for prevention, treatment and prognosis.

Studies have also shown that migraine is associated with a wide range of sleep disturbances. “Poor sleep quality is one of the most common sleep disturbances in migraine patients and may have an impact on the chronicity of migraine,” says Zhujing Liu. However, data on the relationship between the quality of sleep and the risk of developing migraine have not been fully clarified in clinical research.

The Pittsburgh Sleep Quality Index (PSQI) is a self-reported sleep quality questionnaire that assesses sleep quality over the past month and can be used to assess poor sleep quality in migraine patients . Considering the previously documented relationship between sleep and migraine in published research, the PSQI score may be useful as a predictor of migraine. However, few analyzes have reported on the predictive value of PSQI scores for migraine.

for a study published in Frontiers in Neurology, Liu and colleagues systematically explored the relationship between sleep quality and the risks of developing migraine; He also reviewed gender and age differences. They examined the relationship between sleep quality and total pain burden, severity, disability, headache impact, QoL, anxiety, and depression. Sleep quality was assessed using the PSQI. In total, 134 migraine patients and 70 gender- and age-matched healthy controls were included in the analysis.

Poor sleep more common in migraine patients

According to the results, poor sleep quality was significantly higher in migraine patients than those who did not have a headache disorder. “About two-thirds of migraine patients had poor sleep quality, and poor sleep quality was associated with an increased risk of migraine,” Liu says.

After adjusting for various confounding factors, the risk of developing migraine was still 3.981 times greater among people with poor sleep quality than those with good sleep quality. Additionally, the authors noted that the PSQI score for migraine had good diagnostic specificity.

In a subgroup analysis, the investigators observed significant additive interactions between poor sleep quality and risk of migraine by gender, age, and education level. Stronger correlations were found among women, patients age 35 and older, and those with lower education levels. (table), Furthermore, a multivariate linear regression analysis revealed that poor sleep quality in migraine patients was significantly and independently associated with total pain burden, severity, headache impact, QoL, anxiety and depression.

Incorporating sleep quality into migraine treatment

According to Liu, the relationship between sleep quality and migraine-related burden is an important topic that deserves more attention. The present study showed that poor sleep quality was significantly and independently associated with a higher risk of developing migraine and migraine-related burden. According to Liu and colleagues, this information could be used to develop new interventions to improve prevention and treatment of migraine-related burden.

The authors also recommend using the PSQI assessment when evaluating patients with migraine.

“The PSQI tool is convenient, practical and accurate for assessing sleep quality,” says Liu. “It may also guide early prevention and sleep intervention efforts when managing patients with migraine.”

Since the PSQI score had good predictive accuracy and diagnostic specificity for migraine, it may be a potential predictor for migraine, but this requires further validation in future research.

The study team hopes to expand the sample size in future research to explore the effect of preventive treatment on the relationship between sleep quality and migraines. Studies are also needed to determine whether the association between sleep quality and migraine differs based on whether patients receive preventive migraine treatment.

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