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Excessive Daytime Sleepiness in Migraine Patients
Peres MF, Stiles MA, Siow HC, et al.
Posted September 2002
Headache 2002; 42:407


Introduction:  Excessive daytime sleepiness (EDS) is one of the most common sleep complaints. EDS indicates the occurrence of abnormal sleepiness during the normal waking hours. Many neurological disorders are known to cause EDS, including brain tumors, epilepsy, stroke, degenerative diseases, trauma, MS and neuromuscular disorders. Migraine is a debilitating and common disorder but little is known whether it may disrupt nocturnal sleep, leading to sleep deprivation and EDS.

Methods:  We studied 200 consecutive patients with chronic (transformed) and episodic migraine diagnosed according to the 1996 Silbersteinís proposed diagnostic criteria for chronic migraine, and the 1988 International Headache Society diagnostic criteria for migraine were studied. The Epworth Sleepiness Scale (ESS) was applied to all patients, and compared to the diagnosis of chronic/episodic migraine, age, gender, body mass index and headache frequency. Questions on mental and physical fatigue, concentration and memory problems, were rated in a 1 to 5 scale. EDS was defined as an ESS score 10 or higher.

Conclusions:  Excessive daytime sleepiness is a common problem in migraine patients; it is present in 37% of patients (ESS 10 or higher). Headache after dozing off is also common. Dozing off may be a migraine trigger. EDS may reflect a poor prognosis in migraine.