Top

The Journal of Headache and Pain

Published in:

Open Access 01-12-2017 | Research article

Insomnia in tension-type headache: a population-based study

Authors: Jiyoung Kim, Soo-Jin Cho, Won-Joo Kim, Kwang Ik Yang, Chang-Ho Yun, Min Kyung Chu

Published in: The Journal of Headache and Pain | Issue 1/2017

Abstract

Background

Tension-type headache (TTH) represents the most common type of headache among the general population. Although such headaches are usually mild in severity, some individuals with TTH experience severe symptoms and psychiatric comorbidities. Such patients may also experience sleep disturbances, which have been associated with headache exacerbation. Nevertheless, information regarding the prevalence and impact of insomnia among individuals with TTH in a population-based setting is limited. Therefore, the aim of the present study was to evaluate the prevalence and impact of insomnia among individuals with TTH using data from the Korean Headache-Sleep Study (KHSS).

Methods

We analysed data from the KHSS—a nation-wide, cross-sectional, population-based survey on headache and sleep involving Korean adults aged 19 to 69 years. Insomnia was defined as an Insomnia Severity Index score ≥ 10.

Results

Among 2695 participants, 570 (21.2%) and 290 (10.8%) were classified as having TTH and insomnia, respectively. Among individuals with TTH, 113 (19.8%) met the criteria for probable migraine (PM). The prevalence of insomnia among individuals with TTH was significantly higher than that among individuals without headache (13.2% vs. 5.8%, p < 0.001). However, among the TTH group, the prevalence of insomnia did not significantly differ between participants fulfilling PM criteria and those not fulfilling PM criteria (14.2% vs. 12.9%, p = 0.725). Among individuals with TTH, headache frequency [median and interquartile range (IQR): 1.0 (0.3–3.0) vs. 0.4 (0.2–1.0), p = 0.002], visual analogue scale scores for headache intensity [median and IQR: 5.0 (4.0–7.0) vs. 4.0 (3.0–6.0), p < 0.001], Headache Impact Test-6 scores [median and IQR: 46.0 (40.0–52.0) vs. 42.0 (38.0–46.0), p < 0.001], anxiety prevalence (28.0% vs. 6.7%, p < 0.001), and depression prevalence (21.3% vs. 1.6%, p < 0.001) were significantly higher in those with insomnia than in those without insomnia.

Conclusions

Our findings indicate that insomnia is prevalent among individuals with TTH. Moreover, insomnia was associated with exacerbation of headache symptoms and psychiatric comorbidities. Therefore, identification of insomnia among individuals with TTH is required to improve the management of headache symptoms in such patients.

Available only for authorised users

Stovner L, Hagen K, Jensen R, Katsarava Z, Lipton R, Scher A, Steiner T, Zwart JA (2007) The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia 27(3):193–210CrossRefPubMed

Spierings EL, Ranke AH, Honkoop PC (2001) Precipitating and aggravating factors of migraine versus tension-type headache. Headache 41(6):554–558CrossRefPubMed

Rains JC, Davis RE, Smitherman TA (2015) Tension-type headache and sleep. Curr Neurol Neurosci Rep 15(2):520CrossRefPubMed

Lyngberg AC, Rasmussen BK, Jorgensen T, Jensen R (2005) Prognosis of migraine and tension-type headache: a population-based follow-up study. Neurology 65(4):580–585CrossRefPubMed

Morin CM, LeBlanc M, Daley M, Gregoire JP, Merette C (2006) Epidemiology of insomnia: prevalence, self-help treatments, consultations, and determinants of help-seeking behaviors. Sleep Med 7(2):123–130CrossRefPubMed

Daley M, Morin CM, LeBlanc M, Gregoire JP, Savard J, Baillargeon L (2009) Insomnia and its relationship to health-care utilization, work absenteeism, productivity and accidents. Sleep Med 10(4):427–438CrossRefPubMed

Bolge SC, Doan JF, Kannan H, Baran RW (2009) Association of insomnia with quality of life, work productivity, and activity impairment. Qual Life Res 18(4):415–422CrossRefPubMed

Kim K, Uchiyama M, Liu X, Shibui K, Ohida T, Ogihara R, Okawa M (2001) Somatic and psychological complaints and their correlates with insomnia in the Japanese general population. Psychosom Med 63(3):441–446CrossRefPubMed

Sutton DA, Moldofsky H, Badley EM (2001) Insomnia and health problems in Canadians. Sleep 24(6):665–670CrossRefPubMed

10.

Odegard SS, Engstrom M, Sand T, Stovner LJ, Zwart JA, Hagen K (2010) Associations between sleep disturbance and primary headaches: the third Nord-Trondelag health study. J Headache Pain 11(3):197–206CrossRefPubMedPubMedCentral

11.

Odegard SS, Sand T, Engstrom M, Zwart JA, Hagen K (2013) The impact of headache and chronic musculoskeletal complaints on the risk of insomnia: longitudinal data from the Nord-Trondelag health study. J Headache Pain 14:24CrossRefPubMedPubMedCentral

12.

Odegard SS, Sand T, Engstrom M, Stovner LJ, Zwart JA, Hagen K (2011) The long-term effect of insomnia on primary headaches: a prospective population-based cohort study (HUNT-2 and HUNT-3). Headache 51(4):570–580CrossRefPubMed

13.

Ong JC, Stepanski EJ, Gramling SE (2009) Pain coping strategies for tension-type headache: possible implications for insomnia? J Clin Sleep Med 5(1):52–56PubMedPubMedCentral

14.

Sancisi E, Cevoli S, Vignatelli L, Nicodemo M, Pierangeli G, Zanigni S, Grimaldi D, Cortelli P, Montagna P (2010) Increased prevalence of sleep disorders in chronic headache: a case-control study. Headache 50(9):1464–1472CrossRefPubMed

15.

Cho SJ, Chung YK, Kim JM, Chu MK (2015) Migraine and restless legs syndrome are associated in adults under age fifty but not in adults over fifty: a population-based study. J Headache Pain 16:554CrossRefPubMed

16.

Kim B-K, Chu MK, Lee TG, Kim J-M, Chung C-S, Lee K-S (2012) Prevalence and impact of migraine and tension-type headache in Korea. J Clin Neurol 8(3):204–211CrossRefPubMedPubMedCentral

17.

Bastien CH, Vallieres A, Morin CM (2001) Validation of the insomnia severity index as an outcome measure for insomnia research. Sleep Med 2(4):297–307CrossRefPubMed

18.

Morin CM, Belleville G, Belanger L, Ivers H (2011) The insomnia severity index: psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep 34(5):601–608CrossRefPubMedPubMedCentral

19.

Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ (1989) The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res 28(2):193–213CrossRefPubMed

20.

Goldberg D, Bridges K, Duncan-Jones P, Grayson D (1988) Detecting anxiety and depression in general medical settings. BMJ 297(6653):897–899CrossRefPubMedPubMedCentral

21.

Lim JY, Lee SH, Cha YS, Park HS, Sunwoo S (2001) Reliability and validity of anxiety screening scale. J Korean Acad Fam Med 22(8):1224–1232

22.

Pignone MP, Gaynes BN, Rushton JL, Burchell CM, Orleans CT, Mulrow CD, Lohr KN (2002) Screening for depression in adults: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 136(10):765–776CrossRefPubMed

23.

Choi HS, Choi JH, Park KH, Joo KJ, Ga H, Ko HJ, Kim SR (2007) Standardization of the Korean version of patient health questionnaire-9 as a screening instrument for major depressive disorder. J Korean Acad Fam Med 28(2):114–119

24.

Little RJ, Rubin DB (2014) Statistical analysis with missing data. New York: John Wiley & Sons

25.

Lateef T, Swanson S, Cui L, Nelson K, Nakamura E, Merikangas K (2011) Headaches and sleep problems among adults in the United States: findings from the National Comorbidity Survey-Replication study. Cephalalgia 31(6):648–653CrossRefPubMed

26.

Yeung WF, Chung KF, Wong CY (2010) Relationship between insomnia and headache in community-based middle-aged Hong Kong Chinese women. J Headache Pain 11(3):187–195CrossRefPubMedPubMedCentral

27.

Jansson-Frojmark M, Lindblom K (2008) A bidirectional relationship between anxiety and depression, and insomnia? A prospective study in the general population. J Psychosom Res 64(4):443–449CrossRefPubMed

28.

Johnson EO, Roth T, Breslau N (2006) The association of insomnia with anxiety disorders and depression: exploration of the direction of risk. J Psychiatr Res 40(8):700–708CrossRefPubMed

29.

Serafini G, Pompili M, Innamorati M, Gentile G, Borro M, Lamis DA, Lala N, Negro A, Simmaco M, Girardi P, Martelletti P (2012) Gene variants with suicidal risk in a sample of subjects with chronic migraine and affective temperamental dysregulation. Eur Rev Med Pharmacol Sci 16(10):1389–1398PubMed

30.

Houle TT, Butschek RA, Turner DP, Smitherman TA, Rains JC, Penzien DB (2012) Stress and sleep duration predict headache severity in chronic headache sufferers. Pain 153(12):2432–2440CrossRefPubMedPubMedCentral

31.

Song TJ, Cho SJ, Kim WJ, Yang KI, Yun CH, Chu MK (2016) Anxiety and depression in tension-type headache: a population-based study. PLoS One 11(10):e0165316CrossRefPubMedPubMedCentral

32.

Wang J, Huang Q, Li N, Tan G, Chen L, Zhou J (2013) Triggers of migraine and tension-type headache in China: a clinic-based survey. Eur J Neurol 20(4):689–696CrossRefPubMed

33.

Onen SH, Alloui A, Gross A, Eschallier A, Dubray C (2001) The effects of total sleep deprivation, selective sleep interruption and sleep recovery on pain tolerance thresholds in healthy subjects. J Sleep Res 10(1):35–42CrossRefPubMed

34.

Lentz MJ, Landis CA, Rothermel J, Shaver JL (1999) Effects of selective slow wave sleep disruption on musculoskeletal pain and fatigue in middle aged women. J Rheumatol 26(7):1586–1592PubMed

35.

Geiger-Brown JM, Rogers VE, Liu W, Ludeman EM, Downton KD, Diaz-Abad M (2015) Cognitive behavioral therapy in persons with comorbid insomnia: a meta-analysis. Sleep Med Rev 23:54–67CrossRefPubMed

36.

Ohayon MM, Roth T (2003) Place of chronic insomnia in the course of depressive and anxiety disorders. J Psychiatr Res 37(1):9–15CrossRefPubMed

37.

Oh K, Cho SJ, Chung YK, Kim JM, Chu MK (2016) Erratum to: combination of anxiety and depression is associated with an increased headache frequency in migraineurs: a population-based study. BMC Neurol 16:51CrossRefPubMedPubMedCentral

38.

American Academy of Sleep Medicine (2014) International classification of sleep Sisorders—third edition (ICSD-3). American Academy of Sleep Medicine Resource Library Avialble via DIALOG. http://www.aasmnet.org/library/default.aspx. Accessed 20 Aug 2017.

Title: Insomnia in tension-type headache: a population-based study
Authors: Jiyoung Kim
Soo-Jin Cho
Won-Joo Kim
Kwang Ik Yang
Chang-Ho Yun
Min Kyung Chu
Publication date: 01-12-2017
Publisher: Springer Milan
Published in: The Journal of Headache and Pain / Issue 1/2017
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI: https://doi.org/10.1186/s10194-017-0805-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Insomnia in tension-type headache: a population-based study

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2017

Simulated airplane headache: a proxy towards identification of underlying mechanisms

Altered functional connectivity of amygdala underlying the neuromechanism of migraine pathogenesis

Lower inhibitory control interacts with greater pain catastrophizing to predict greater pain intensity in women with migraine and overweight/obesity

Experts’ opinion about the pediatric secondary headaches diagnostic criteria of the ICHD-3 beta

Duration and frequency of migraines affect cognitive function: evidence from neuropsychological tests and event-related potentials

Family studies to find rare high risk variants in migraine