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Migraine Attacks and Sleep in Children
Aaltonen K, Hamalainen ML, Hoppu K.
Posted: February 2003  
Cephalalgia 2000; 20:580-584

Falling asleep as a means of ending migraine attack was studied in 133 4-16 year old children in out-patient settings. Children registered 999 migraine attacks in headache diaries using a visual analogue scale (VAS) in 409 attacks and a five-face scale in 590 attacks. The distribution of maximal pain intensity was similar on both scales; on VAS 88% assigned grades between 63 and 100, and on the face scale 93% assigned grades of 4 or 5. Children fell asleep during 33% of the attacks, in 64% of these within the first hour. Of the children, 68% had fallen asleep at least once during an attack. Falling asleep was more common in children under 8 years of age than in older children. In those under 8 years, 62% of attacks were resolved by sleep, in those aged 8-12 years 34% and in children older than 12 years, 24%. Pain was relieved without sleep in 43% of attacks, in 38% of these within the first 4 hours. The data on migraine resolution were missing for 24% of the attacks, most often because the attack exceeded the 5-hour observation period. This study confirms that migraine attacks in children are extremely painful and often resolve during an interval of sleep in children under 8 years of age.