Acta Neurologica Belgica

, Volume 113, Issue 3, pp 229–235

Prevalence and predictive factors for poor sleep quality among migraineurs in a tertiary hospital headache clinic

  • Zhou Zhu
  • Xiaoping Fan
  • Xuelian Li
  • Ge Tan
  • Lixue Chen
  • Jiying Zhou
Original Article

Abstract

The aim of this study was to investigate the prevalence and predictive factors for poor sleep quality among migraineurs in a tertiary hospital headache clinic in southwest China. In this study, we used a visual analog scale (VAS), the Pittsburgh Sleep Quality Index (PSQI), and the Hospital Anxiety and Depression Scale (HADS) to assess headache intensity, sleep quality as well as anxiety and depression symptoms. In 211 subjects who were assessed continuously, we found that the average PSQI score was 8.03 ± 4.71, and 130 (61.61 %) migraineurs exhibited poor sleep quality (PSQI >5). Poor sleep quality was largely expressed as experiencing an extended sleep latency period, daytime dysfunction, poor subjective sleep quality, and short sleep duration. The primary factors that predicted poor sleep quality included the migraine history and comorbidity with anxiety and/or depression. Moreover, we found that most migraineurs did not adopt treatment for their poor sleep quality. Only 17 (8.06 %) patients used sleeping medication to improve their poor sleep quality; however, this medication was not effective in 16 (94.12 %) patients. Therefore, it is highly important to resolve poor sleep quality in migraineurs.

Keywords

Migraine Sleep quality Predictive factors Anxiety Depression 

Abbreviations

PSQI

Pittsburgh Sleep Quality Index

HADS

Hospital Anxiety and Depression Scale

VAS

Visual analog scale

MA

Migraine with aura

MO

Migraine without aura

References

  1. 1.
    Yu S, Liu R, Zhao G, Yang X, Qiao X et al (2012) The prevalence and burden of primary headaches in China: a population-based door-to-door survey. Headache 54(4):582–591CrossRefGoogle Scholar
  2. 2.
    Lipton RB, Pan J (2004) Is migraine a progressive brain disease? JAMA 291(4):493–494PubMedCrossRefGoogle Scholar
  3. 3.
    Scher AI, Stewart WF, Ricci JA, Lipton RB (2003) Factors associated with the onset and remission of chronic daily headache in a population-based study. Pain 106(1–2):81–89PubMedCrossRefGoogle Scholar
  4. 4.
    Hazard E, Munakata J, Bigal ME, Rupnow MF, Lipton RB (2008) The burden of migraine in the United States: current and emerging perspectives on disease management and economic analysis. Int Soc Pharmacoecon Outcomes Res (ISPOR) 09(1098–3015):55–64Google Scholar
  5. 5.
    Breslau N (1998) Psychiatric comorbidity in migraine. Cephalalgia 18:56–58 (discussion 58–61)Google Scholar
  6. 6.
    Scher AI, Stewart WF, Lipton RB (2006) The comorbidity of headache with other pain syndromes. Headache 46(9):1416–1423PubMedCrossRefGoogle Scholar
  7. 7.
    Vgontzas A, Cui L, Merikangas KR (2008) Are sleep difficulties associated with migraine attributable to anxiety and depression? Headache 48(10):1451–1459PubMedCrossRefGoogle Scholar
  8. 8.
    Sevillano-García MD, Manso-Calderón R, Cacabelos-Pérez P (2007) Comorbidity in the migraine: depression, anxiety, stress and insomnia. Rev Neurol 45(7):400–405PubMedGoogle Scholar
  9. 9.
    Hamelsky SW, Lipton RB (2006) Psychiatric comorbidity of migraine. Headache 46(9):1327–1333PubMedCrossRefGoogle Scholar
  10. 10.
    Michael T, Margraf J (2004) Epidemiology of anxiety disorders. Psychiatry 3(4):2–6CrossRefGoogle Scholar
  11. 11.
    Ball HA, Siribaddana SH, Kovas Y, Glozier N, McGuffin P et al (2010) Epidemiology and symptomatology of depression in Sri Lanka: a crosssectional population-based survey in Colombo District. J Affect Disord 123(1–3):188–196PubMedCrossRefGoogle Scholar
  12. 12.
    Doi Y, Minowa M, Uchiyama M, Okawa M (2001) Subjective sleep quality and sleep problems in the general Japanese adult population. Psychiatry Clin Neurosci 55(3):213–215PubMedCrossRefGoogle Scholar
  13. 13.
    Alberti A (2006) Headache and sleep. Sleep Med Rev 10(6):431–437PubMedCrossRefGoogle Scholar
  14. 14.
    Rains JC, Poceta JS (2005) Sleep-related headache syndromes. Semin Neurol 25(1):69–80PubMedCrossRefGoogle Scholar
  15. 15.
    Kelman L, Rains JC (2005) Headache and sleep: examination of sleep patterns and complaints in a large clinical sample of migraineurs. Headache 45(7):904–910PubMedCrossRefGoogle Scholar
  16. 16.
    Mellman TA (2006) Sleep and anxiety disorders. Psychiatr Clin North Am 29(4):1047–1058PubMedCrossRefGoogle Scholar
  17. 17.
    Riemann D, Berger M, Voderholzer U (2001) Sleep and depression—results from psychobiological studies: an overview. Biol Psychol 57(1–3):67–103PubMedCrossRefGoogle Scholar
  18. 18.
    Hung CI, Liu CY, Juang YY, Wang SJ (2006) The impact of migraine on patients with major depressive disorder. Headache 46(3):469–477PubMedCrossRefGoogle Scholar
  19. 19.
    Hung CI, Liu CY, Fuh JL, Juang YY, Wang SJ (2006) Comorbid migraine is associated with a negative impact on quality of life in patients with major depression. Cephalalgia 26(1):26–32PubMedCrossRefGoogle Scholar
  20. 20.
    Oedegaard KJ, Fasmer OB (2005) Is migraine in unipolar depressed patients a bipolar spectrum trait? J Affect Disord 84(2–3):233–242PubMedCrossRefGoogle Scholar
  21. 21.
    Breslau N, Lipton RB, Stewart WF, Schultz LR, Welch KM (2003) Comorbidity of migraine and depression: investigating potential etiology and prognosis. Neurology 60(8):1308–1312PubMedCrossRefGoogle Scholar
  22. 22.
    Dodick DW, Eross EJ, Parish JM, Silber M (2003) Clinical, anatomical, and physiologic relationship between sleep and headache. Headache 43(3):282–292PubMedCrossRefGoogle Scholar
  23. 23.
    Headache Society (2004) The International Classification of Headache disorders. Cephalagia 24:1–160Google Scholar
  24. 24.
    Tsai PS, Wang SY, Wang MY, Su CT, Yang TT et al (2005) Psychometric evaluation of the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI) in primary insomnia and control subjects. Qual Life Res 14(8):1943–1952PubMedCrossRefGoogle Scholar
  25. 25.
    Buysee D, Reynolds C, Monk T (1989) The Pittsburgh Sleep Quality Index: a new instrument for psychiatry practice and research. Psychiatry Res 28:198–213Google Scholar
  26. 26.
    Backhaus J, Junghanns K, Broocks A, Riemann D, Hohagen F (2002) Test–retest reliability and validity of the Pittsburgh Sleep Quality Index in primary insomnia. J Psychosom Res 53(3):737–740PubMedCrossRefGoogle Scholar
  27. 27.
    Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67(6):361–370PubMedCrossRefGoogle Scholar
  28. 28.
    Lam CL, Pan PC, Chan AW, Chan SY, Munro C (1995) Can the Hospital Anxiety and Depression (HAD) Scale be used on Chinese elderly in general practice? Fam Pract 12(2):149–154PubMedCrossRefGoogle Scholar
  29. 29.
    Bjelland I, Dahl AA, Haug TT, Neckelmann D (2002) The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res 52(2):69–77PubMedCrossRefGoogle Scholar
  30. 30.
    Todd KH, Funk KG, Funk JP, Bonacci R (1996) Clinical significance of reported changes in pain severity. Ann Emerg Med 27(4):485–489PubMedCrossRefGoogle Scholar
  31. 31.
    Schmitz N, Admirall-behloul F, Arkink EB, Kruit MC, Schoonman GG et al (2008) Attack frequency and disease duration as indicators for brain damage in migraine. Headache 48(7):1044–1055PubMedCrossRefGoogle Scholar
  32. 32.
    Carotenuto M, Guidetti V, Ruju F, Galli F, Tagliente FR et al (2005) Headache disorders as risk factors for sleep disturbances in school aged children. J Headache Pain 6(4):268–270PubMedCrossRefGoogle Scholar
  33. 33.
    Chung KF, Tang MK (2006) Subjective sleep disturbance and its correlates in middle-aged Hong Kong Chinese women. Maturitas 53(4):396–404PubMedCrossRefGoogle Scholar
  34. 34.
    Montagna P (2006) Hypothalamus, sleep and headaches. Neurol Sci 27(Suppl 2):138–143CrossRefGoogle Scholar
  35. 35.
    Manber R, Armitage R (1999) Sex, steroids, and sleep: a review. Sleep 22(5):540–555PubMedGoogle Scholar
  36. 36.
    Manber R, Bootzin RR (1997) Sleep and the menstrual cycle. Health Psychol 16(3):209–214PubMedCrossRefGoogle Scholar
  37. 37.
    Young T, Rabago D, Zgierska A, Austin D, Laurel F (2003) Objective and subjective sleep quality in premenopausal, perimenopausal, and postmenopausal women in the Wisconsin Sleep Cohort Study. Sleep 26(6):667–672PubMedGoogle Scholar
  38. 38.
    Naughton F, Ashworth P, Skevington SM (2007) Does sleep quality predict pain-related disability in chronic pain patients? The mediating roles of depression and pain severity. Pain 127(3):243–252PubMedCrossRefGoogle Scholar
  39. 39.
    Rains JC (2010) Headache currents: headache and sleep. Headache 50(7):1252–1254PubMedCrossRefGoogle Scholar
  40. 40.
    Eli R, Fasciano JA (2006) A chronopharmacological preventive treatment for sleep-related migraine headaches and chronic morning headaches: nitric oxide supersensitivity can cause sleep-related headaches in a subset of patients. Med Hypotheses 66(3):461–465PubMedCrossRefGoogle Scholar

Copyright information

© Belgian Neurological Society 2012

Authors and Affiliations

  • Zhou Zhu
    • 1
  • Xiaoping Fan
    • 1
  • Xuelian Li
    • 1
  • Ge Tan
    • 1
  • Lixue Chen
    • 2
  • Jiying Zhou
    • 1
  1. 1.Department of NeurologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingPeople’s Republic of China
  2. 2.Laboratory Research Center, Chongqing Key Laboratory of NeurologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingPeople’s Republic of China

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