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Sleep-related and non-sleep-related migraine: interictal sleep quality, arousals and pain thresholds.

Engstrøm M, Hagen K, Bjørk M, Gravdahl GB, Sand T - J Headache Pain (2013)

Bottom Line: NSM patients had PSG findings indicating foregoing sleep deprivation.As foregoing sleep times were normal, a relative sleep deficit might explain reduced PT among NSM patients.The SM patients had signs of slightly disturbed sleep.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Clinical Neurosciences, PB 8905, MTFS, Norwegian University of Science and Technology, Trondheim N-7489, Norway. morten.engstrom@ntnu.no.

ABSTRACT

Background: The mechanisms associating sleep and migraine are unknown. No previous polysomnographic (PSG) or pain-threshold (PT) study has compared patients with sleep-related migraine attacks (SM), non-sleep related migraine attacks (NSM) and healthy controls.

Methods: We have performed a blinded, prospective exploratory study with case-control design. Thirty-four healthy controls, 15 patients with SM and 18 patients with NSM had interictal PSG heat-, cold- and pressure PT (HPT, CPT, PPT) recordings and completed diary- and questionnaire on sleep and headache related aspects.

Results: NSM patients had more slow-wave sleep (SWS) and more K-bursts than SM patients (K-bursts: p = 0.023 and SWS: p = 0.030) and controls (K-bursts: p = 0.009 and SWS: 0.041). NSM patients also had lower HPT and CPT than controls (p = 0.026 and p = 0.021). In addition, SM patients had more awakenings and less D-bursts than controls (p = 0.025 and p = 0.041).

Conclusion: SM- and NSM patients differed in objective-, but not subjective sleep quality. NSM patients had PSG findings indicating foregoing sleep deprivation. As foregoing sleep times were normal, a relative sleep deficit might explain reduced PT among NSM patients. The SM patients had signs of slightly disturbed sleep.

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Related in: MedlinePlus

Pressure pain thresholds and amount of slow wave sleep (SWS) in sleep related migraine (SM, solid line) and non-sleep related migraine (NSM, dotted line). Less N3 sleep was significantly associated with high pressure pain thresholds in the NSM group (age adjusted r = -0.50. p < 0.05).
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Figure 1: Pressure pain thresholds and amount of slow wave sleep (SWS) in sleep related migraine (SM, solid line) and non-sleep related migraine (NSM, dotted line). Less N3 sleep was significantly associated with high pressure pain thresholds in the NSM group (age adjusted r = -0.50. p < 0.05).

Mentions: Among NSM patients the amount of sleep stage N1 correlated positively with headache frequency (Table 4). The amount of N3 sleep correlated negatively with PPT (Table 4, Figure 1). The amount of KD-bursts correlated negatively with TPT (Figure 2) and headache frequency (Table 4). Among SM patients, the KD-index tended to correlate positively with PPT. The amount of N2 sleep correlated negatively with insomnia and positively with PPT. The amount of sleep stage N3 correlated negatively with headache history duration. Among controls we found no significant correlations in objective versus subjective quality scores or versus PT (not tabulated).


Sleep-related and non-sleep-related migraine: interictal sleep quality, arousals and pain thresholds.

Engstrøm M, Hagen K, Bjørk M, Gravdahl GB, Sand T - J Headache Pain (2013)

Pressure pain thresholds and amount of slow wave sleep (SWS) in sleep related migraine (SM, solid line) and non-sleep related migraine (NSM, dotted line). Less N3 sleep was significantly associated with high pressure pain thresholds in the NSM group (age adjusted r = -0.50. p < 0.05).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3750452&req=5

Figure 1: Pressure pain thresholds and amount of slow wave sleep (SWS) in sleep related migraine (SM, solid line) and non-sleep related migraine (NSM, dotted line). Less N3 sleep was significantly associated with high pressure pain thresholds in the NSM group (age adjusted r = -0.50. p < 0.05).
Mentions: Among NSM patients the amount of sleep stage N1 correlated positively with headache frequency (Table 4). The amount of N3 sleep correlated negatively with PPT (Table 4, Figure 1). The amount of KD-bursts correlated negatively with TPT (Figure 2) and headache frequency (Table 4). Among SM patients, the KD-index tended to correlate positively with PPT. The amount of N2 sleep correlated negatively with insomnia and positively with PPT. The amount of sleep stage N3 correlated negatively with headache history duration. Among controls we found no significant correlations in objective versus subjective quality scores or versus PT (not tabulated).

Bottom Line: NSM patients had PSG findings indicating foregoing sleep deprivation.As foregoing sleep times were normal, a relative sleep deficit might explain reduced PT among NSM patients.The SM patients had signs of slightly disturbed sleep.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Clinical Neurosciences, PB 8905, MTFS, Norwegian University of Science and Technology, Trondheim N-7489, Norway. morten.engstrom@ntnu.no.

ABSTRACT

Background: The mechanisms associating sleep and migraine are unknown. No previous polysomnographic (PSG) or pain-threshold (PT) study has compared patients with sleep-related migraine attacks (SM), non-sleep related migraine attacks (NSM) and healthy controls.

Methods: We have performed a blinded, prospective exploratory study with case-control design. Thirty-four healthy controls, 15 patients with SM and 18 patients with NSM had interictal PSG heat-, cold- and pressure PT (HPT, CPT, PPT) recordings and completed diary- and questionnaire on sleep and headache related aspects.

Results: NSM patients had more slow-wave sleep (SWS) and more K-bursts than SM patients (K-bursts: p = 0.023 and SWS: p = 0.030) and controls (K-bursts: p = 0.009 and SWS: 0.041). NSM patients also had lower HPT and CPT than controls (p = 0.026 and p = 0.021). In addition, SM patients had more awakenings and less D-bursts than controls (p = 0.025 and p = 0.041).

Conclusion: SM- and NSM patients differed in objective-, but not subjective sleep quality. NSM patients had PSG findings indicating foregoing sleep deprivation. As foregoing sleep times were normal, a relative sleep deficit might explain reduced PT among NSM patients. The SM patients had signs of slightly disturbed sleep.

Show MeSH
Related in: MedlinePlus