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The Journal of Headache and Pain
Published in: The Journal of Headache and Pain 1/2013

Open Access 01-12-2013 | Research article

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

Authors: Morten Engstrøm, Knut Hagen, Marte Bjørk, Gøril Bruvik Gravdahl, Trond Sand

Published in: The Journal of Headache and Pain | Issue 1/2013

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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.
Appendix
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Literature
1.
Gori S, Morelli N, Maestri M, Fabbrini M, Bonanni E, Murri L: Sleep quality, chronotypes and preferential timing of attacks in migraine without aura. J Headache Pain 2005,6(4):258–260. 10.1007/s10194-005-0201-2PubMedCentralPubMedCrossRef
2.
Kelman L, Rains JC: Headache and sleep: examination of sleep patterns and complaints in a large clinical sample of migraineurs. Headache 2005,45(7):904–910. 10.1111/j.1526-4610.2005.05159.xPubMedCrossRef
3.
Olesen J: The International Classification of Headache Disorders: 2nd edition. Cephalalgia 2004,24(Suppl 1):9–160.CrossRef
4.
Kelman L: The triggers or precipitants of the acute migraine attack. Cephalalgia 2007,27(5):394–402. 10.1111/j.1468-2982.2007.01303.xPubMedCrossRef
5.
Andress-Rothrock D, King W, Rothrock J: An analysis of migraine triggers in a clinic-based population. Headache 2010,50(8):1366–1370. 10.1111/j.1526-4610.2010.01753.xPubMedCrossRef
6.
American Academy of Sleep Medicine: International classification of sleep disorders 2nd edition: Diagnostic and coding manual. 2nd edition. Westchester, Illinois: American Academy of Sleep Medicine; 2005.
7.
Rains JC: Morning headache in habitual snorers. Cephalalgia 2011,31(9):981–983. 10.1177/0333102411411204PubMedCrossRef
8.
Ulfberg J, Carter N, Talback M, Edling C: Headache, snoring and sleep apnoea. J Neurol 1996,243(9):621–625. 10.1007/BF00878656PubMedCrossRef
9.
Alstadhaug K, Salvesen R, Bekkelund S: Insomnia and circadian variation of attacks in episodic migraine. Headache 2007,47(8):1184–1188. 10.1111/j.1526-4610.2007.00858.xPubMedCrossRef
10.
Odegard SS, Engstrom M, Sand T, Stovner LJ, Zwart JA, Hagen K: Associations between sleep disturbance and primary headaches: the third Nord-Trondelag Health Study. J Headache Pain 2010,11(3):197–206. 10.1007/s10194-010-0201-8PubMedCentralPubMedCrossRef
11.
Dodick DW, Eross EJ, Parish JM, Silber M: Clinical, anatomical, and physiologic relationship between sleep and headache. Headache 2003,43(3):282–292. 10.1046/j.1526-4610.2003.03055.xPubMedCrossRef
12.
Paiva T, Batista A, Martins P, Martins A: The relationship between headaches and sleep disturbances. Headache 1995,35(10):590–596. 10.1111/j.1526-4610.1995.hed3510590.xPubMedCrossRef
13.
Holzhammer J, Wober C: Non-alimentary trigger factors of migraine and tension-type headache. Schmerz 2006,20(3):226–237. 10.1007/s00482-005-0413-zPubMedCrossRef
14.
Della Marca G, Vollono C, Rubino M, Di Trapani G, Mariotti P, Tonali PA: Dysfunction of arousal systems in sleep-related migraine without aura. Cephalalgia 2006,26(7):857–864. 10.1111/j.1468-2982.2006.01122.xPubMedCrossRef
15.
Goder R, Fritzer G, Kapsokalyvas A, Kropp P, Niederberger U, Strenge H, Gerber WD, Aldenhoff JB: Polysomnographic findings in nights preceding a migraine attack. Cephalalgia 2001,21(1):31–37. 10.1046/j.1468-2982.2001.00141.xPubMedCrossRef
16.
17.
Azevedo E, Manzano GM, Silva A, Martins R, Andersen ML, Tufik S: The effects of total and REM sleep deprivation on laser-evoked potential threshold and pain perception. Pain 2011,152(9):2052–2058. 10.1016/j.pain.2011.04.032PubMedCrossRef
18.
Roehrs T, Hyde M, Blaisdell B, Greenwald M, Roth T: Sleep loss and REM sleep loss are hyperalgesic. Sleep 2006,29(2):145–151.PubMed
19.
Kundermann B, Spernal J, Huber MT, Krieg JC, Lautenbacher S: Sleep deprivation affects thermal pain thresholds but not somatosensory thresholds in healthy volunteers. Psychosom Med 2004,66(6):932–937. 10.1097/01.psy.0000145912.24553.c0PubMedCrossRef
20.
Onen SH, Alloui A, Gross A, Eschallier A, Dubray C: The effects of total sleep deprivation, selective sleep interruption and sleep recovery on pain tolerance thresholds in healthy subjects. J Sleep Res 2001,10(1):35–42. 10.1046/j.1365-2869.2001.00240.xPubMedCrossRef
21.
Smith MT, Edwards RR, McCann UD, Haythornthwaite JA: The effects of sleep deprivation on pain inhibition and spontaneous pain in women. Sleep 2007,30(4):494–505.PubMed
22.
Sand T, Zhitniy N, Nilsen KB, Helde G, Hagen K, Stovner LJ: Thermal pain thresholds are decreased in the migraine preattack phase. Eur J Neurol 2008,15(11):1199–1205. 10.1111/j.1468-1331.2008.02276.xPubMedCrossRef
23.
Engstrom M, Hagen K, Bjork MH, Stovner LJ, Gravdahl GB, Stjern M, Sand T: Sleep quality, arousal and pain thresholds in migraineurs: a blinded controlled polysomnographic study. J Headache Pain 2013,14(1):12. 10.1186/1129-2377-14-12PubMedCentralPubMedCrossRef
24.
Johns MW: A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 1991,14(6):540–545.PubMed
25.
Miletin MS, Hanly PJ: Measurement properties of the Epworth sleepiness scale. Sleep Med 2003,4(3):195–199. 10.1016/S1389-9457(03)00031-5PubMedCrossRef
26.
Engstrøm M, Ødegård SS, Sand T, Stovner LJ, Zwart JA, Hagen K: The reliability of a New Sleep Screening Questionnaire for Large Population-Based Studies: The Third Nord-Trøndelag Health Study The Open Sleep Journal. 2011, 4: 14–19.
27.
Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ: The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989,28(2):193–213. 10.1016/0165-1781(89)90047-4PubMedCrossRef
28.
Zigmond AS, Snaith RP: The hospital anxiety and depression scale. Acta Psychiatr Scand 1983,67(6):361–370. 10.1111/j.1600-0447.1983.tb09716.xPubMedCrossRef
29.
Trenkwalder C, Paulus W, Walters AS: The restless legs syndrome. Lancet neurology 2005,4(8):465–475. 10.1016/S1474-4422(05)70139-3PubMedCrossRef
30.
Klem GH, Luders HO, Jasper HH, Elger C: The ten-twenty electrode system of the International Federation. The International Federation of Clinical Neurophysiology. Electroencephalogr Clin Neurophysiol Suppl 1999, 52: 3–6.PubMed
31.
American Academy of Sleep Medicine Task Force: Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. Sleep 22(5):667–689.
32.
American Academy of Sleep Medicine W: The AASM Manual for the Scoring of Sleep and Associated Events. Rules, Terminology and Technical Specifications. American Academy of Sleep Medicine. IL 60154, U.S.A: Westchester; 2007.
33.
Sforza E, Jouny C, Ibanez V: Cardiac activation during arousal in humans: further evidence for hierarchy in the arousal response. Clin Neurophysiol 2000,111(9):1611–1619. 10.1016/S1388-2457(00)00363-1PubMedCrossRef
34.
Parrino L, Boselli M, Spaggiari MC, Smerieri A, Terzano MG: Cyclic alternating pattern (CAP) in normal sleep: polysomnographic parameters in different age groups. Electroencephalogr Clin Neurophysiol 1998,107(6):439–450. 10.1016/S0013-4694(98)00108-4PubMedCrossRef
35.
Halasz P, Terzano M, Parrino L, Bodizs R: The nature of arousal in sleep. J Sleep Res 2004,13(1):1–23. 10.1111/j.1365-2869.2004.00388.xPubMedCrossRef
36.
37.
Nicholas CL, Trinder J, Colrain IM: Increased production of evoked and spontaneous K-complexes following a night of fragmented sleep. Sleep 2002,25(8):882–887.PubMed
38.
De Gennaro L, Ferrara M, Bertini M: EEG arousals in normal sleep: variations induced by total and selective slow-wave sleep deprivation. Sleep 2001,24(6):673–679.PubMed
39.
Youngberg MR, Karpov IO, Begley A, Pollock BG, Buysse DJ: Clinical and physiological correlates of caffeine and caffeine metabolites in primary insomnia. J Clin Sleep Med 2011,7(2):196–203.PubMedCentralPubMed
40.
Sand T: EEG in migraine: a review of the literature. Funct Neurol 1991,6(1):7–22.PubMed
41.
Terzano MG, Parrino L, Smerieri A, Carli F, Nobili L, Donadio S, Ferrillo F: CAP and arousals are involved in the homeostatic and ultradian sleep processes. J Sleep Res 2005,14(4):359–368. 10.1111/j.1365-2869.2005.00479.xPubMedCrossRef
42.
43.
Zwart JA, Dyb G, Hagen K, Odegard KJ, Dahl AA, Bovim G, Stovner LJ: Depression and anxiety disorders associated with headache frequency. The Nord-Trondelag Health Study. Eur J Neurol 2003,10(2):147–152. 10.1046/j.1468-1331.2003.00551.xPubMedCrossRef
44.
Lanteri-Minet M, Radat F, Chautard MH, Lucas C: Anxiety and depression associated with migraine: influence on migraine subjects' disability and quality of life, and acute migraine management. Pain 2005,118(3):319–326. 10.1016/j.pain.2005.09.010PubMedCrossRef
45.
Porkka-Heiskanen T, Kalinchuk AV: Adenosine, energy metabolism and sleep homeostasis. Sleep Med Rev 2011,15(2):123–135. 10.1016/j.smrv.2010.06.005PubMedCrossRef
46.
Coppola G, Pierelli F, Schoenen J: Habituation and migraine. Neurobiol Learn Mem 2009,92(2):249–259. 10.1016/j.nlm.2008.07.006PubMedCrossRef
47.
Gori S, Lucchesi C, Morelli N, Maestri M, Bonanni E, Murri L: Sleep-related migraine occurrence increases with aging. Acta Neurol Belg 2012,112(2):183–187. 10.1007/s13760-012-0049-6PubMedCrossRef
48.
Johnson KG, Ziemba AM, Garb JL: Improvement in Headaches With Continuous Positive Airway Pressure for Obstructive Sleep Apnea: A Retrospective Analysis. Headache 2012,53(2):333–343.PubMedCrossRef
49.
50.
Keay KA, Bandler R: Parallel circuits mediating distinct emotional coping reactions to different types of stress. Neurosci Biobehav Rev 2001,25(7–8):669–678.PubMedCrossRef
51.
Terzano MG, Parrino L: Origin and Significance of the Cyclic Alternating Pattern (CAP). REVIEW ARTICLE. Sleep Med Rev 2000,4(1):101–123. 10.1053/smrv.1999.0083PubMedCrossRef
52.
Thomas RJ: Cyclic alternating pattern in the electroencephalogram: what is its clinical utility? Sleep 2007,30(5):553–555.PubMed
53.
Sforza E, Chapotot F, Pigeau R, Buguet A: Time of night and first night effects on arousal response in healthy adults. Clin Neurophysiol 2008,119(7):1590–1599. 10.1016/j.clinph.2008.03.010PubMedCrossRef
54.
Schulz KF, Grimes DA: Multiplicity in randomised trials I: endpoints and treatments. Lancet 2005,365(9470):1591–1595. 10.1016/S0140-6736(05)66461-6PubMedCrossRef
Metadata
Title
Sleep-related and non-sleep-related migraine: interictal sleep quality, arousals and pain thresholds
Authors
Morten Engstrøm
Knut Hagen
Marte Bjørk
Gøril Bruvik Gravdahl
Trond Sand
Publication date
01-12-2013
Publisher
Springer Milan
Published in
The Journal of Headache and Pain / Issue 1/2013
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI
https://doi.org/10.1186/1129-2377-14-68

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