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Transformed Migraine Related To Sleep Problems

by Teri Robert, Lead Expert

Although sleep issues have been linked with headaches and Migraine for more than 100 years, information about the types and prevalence of specific sleep problems in adults with transformed Migraine (TM) has been scarce. Now the findings have been published on a study to look at the connection between nonrestorative sleep and TM. The study was conducted at the University of North Carolina in Chapel Hill, led by Dr. Anne Calhoun.

Study objectives:
"It is our clinical observation that patients with transformed migraine (TM) almost invariably report nonrestorative sleep. In this study we sought first to validate that clinical observation, then to describe the prevalence and spectrum of factors that might contribute to nonrestorative sleep in a TM population."

Study methods:

  • Researchers conducted detailed sleep interviews with 147 women with TM.
  • The quality of the subjects' sleep was assessed by asking patients to describe how they felt upon awakening as either "refreshed" or "tired.

Study results:

  • The mean age of study participants was 39.47-years-old.
  • The median length of time participants had been experiencing chronic headache was 66 months.
  • 0 patients responded that they awakened feeling "refreshed."
  • 87% responded that they awakened feeling "tired."
  • Various sleep complaints were prevalent.
  • Difficulty falling asleep was reported by 2/3 of study participants.
  • The reason most commonly reported for disruption of sleep was getting up to urinate.
  • More than 50% of the study participants used sleep medications, with benzodiazapines (the family that includes medication such as Valium and Xanax) being the most commonly used and the users reporting excessive night movements.
  • 73% of the participants reported medication overuse, and these were the participants most likely to report disrupted sleep and awakening during the night. They were also the participants most likely to nap during the day.

Study conclusions:
"Although the relationship between pain and sleep is complex and ill understood, we found a very high prevalence of nonrestorative sleep and a similarly high prevalence of modifiable poor sleep habits in patients with TM. Since behavioral approaches have been found effective in improving sleep quality in patients with poor sleep hygiene, we propose that studies be undertaken to assess the impact of such treatment on TM."

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