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Sleep Disorders with Transformed Migraine
Calhoun AH, et al.
Posted: April 2006  
Headache 2006;46:604-10

Nonrestorative sleep and modifiable poor sleep habits are common in female patients who experience transformed migraine, according to study findings.

A group of 147 women with transformed migraine completed a detailed sleep interview; subjective sleep quality was based on whether the women felt “refreshed” or “tired” when they woke up.

Results showed that none o the respondents felt refreshed upon awakening, and 83.7% said they usually felt tired when they awoke.

The amount of time patients spent in bed varied considerably as did their day-to-day bed and wake times. For example, nearly 20% of the respondents said they spent <6.5 hours in bed, while an equal proportion stayed in bed for >9.5 hours.

Overall, two thirds of the patients had trouble falling asleep, with the most common identifiable cause being activity in bed before sleep: 78.9% of the sample said they made a habit of watching TV or reading in bed. Also, 63.3% of the women said they “habitually” took naps.

In terms of other health conditions, 23.8% and 32.7% of the women reported having restless legs syndrome or a history of snoring, respectively. However, the most commonly reported sleep disruption was nocturnal micturition, due mostly to dietary factors: 68.1% of the women reported wakening to void 1-6 times per night.

The use of slee0 medications, which occurred in 51.7% of the patients, was associated with increased sleep onset latency and nocturia. Furthermore, 72.8% of the patients overused medications; those who overused acute drugs for migraine were more likely to take naps, report sleep disruptions/nocturnal awakenings, have greater headache frequency, and experience headaches of greater severity.

Although the study researchers conceded that the relationship between pain and sleep is not clearly understood, they advised that studies be conducted to evaluate the influence of behavioral approaches -- which have been effective in improving sleep quality in patients with poor sleep hygiene -- on chronic daily headache.