Sleep Duration Linked to Migraine Frequency and Disability

TOPLINEAdults with migraine who reported an average nightly sleep of 6 hours or less (short sleep) or 10 hours or more (long sleep) experienced significantly more headache days per month and greater disability than those who reported an average nightly sleep of 7-9 hours (normal sleep), with the most pronounced burden among those with long sleep, a study showed. Perceived stress statistically accounted for, in part, the links between short or long sleep durations and migraine outcomes.METHODOLOGYResearchers conducted a cross-sectional analysis of the data of 6267 adults with migraine (mean age, 41.5 years; 91.7% women) from the HeAD-US study in 2023.Participants reported their mean nightly sleep durations and headache characteristics and completed the American Migraine Study/American Migraine Prevalence and Prevention migraine diagnostic module.Stress and migraine-related disability were assessed using the Perceived Stress Scale-4 (PSS-4) and the Migraine Disability Assessment (MIDAS) questionnaire, respectively, and anxiety and depression symptoms were screened using the Patient Health Questionnaire-4. The duration of sleep was classified as short (35.3% of the participants), normal (62.2% of the participants), and long (2.5% of the participants).Researchers analyzed associations between sleep durations and the number of monthly headache days (MHDs), MIDAS scores, and perceived stress after adjusting for age, sex, education, and symptoms of anxiety and depression.Cross-sectional mediation analyses tested whether perceived stress statistically accounted for these associations.TAKEAWAYCompared to normal sleep, short sleep was linked to 10.9% more expected MHDs (incidence rate ratio [IRR], 1.11; 95% CI, 1.05-1.17) and 13.6% higher expected MIDAS scores (IRR, 1.14; 95% CI, 1.08-1.20) after full adjustment.Compared to normal sleep, long sleep was linked to 27.1% more expected MHDs (IRR, 1.27; 95% CI, 1.07-1.51) and 66.0% higher expected MIDAS scores (IRR, 1.66; 95% CI, 1.41-1.96) after full adjustment.PSS-4 scores were higher with both short sleep (B = 0.59; 95% CI, 0.46-0.73) and long sleep (B = 0.91; 95% CI, 0.51-1.32) than with normal sleep duration after full adjustment.Perceived stress statistically accounted for about 48% and 30% of the observed associations of number of MHDs with short and long sleep durations, respectively. Similarly, perceived stress statistically accounted for about 70% and 23% of the observed associations of MIDAS scores with short and long sleep durations, respectively.IN PRACTICE"These findings suggest that unhealthy sleep amounts and higher stress are linked to worse migraine burden, and further research is needed to determine whether treating sleep problems and stress can improve migraine outcomes," the investigators wrote.SOURCEThe study was led by Angeliki Vgontzas, MD, Brigham and Women's Hospital, Harvard Medical School, Boston. It was published online on September 28 in Headache.LIMITATIONSThe study was limited by its cross-sectional design, lack of information on sleep disorders, a relatively smaller number of long sleepers, digital recruitment and potential selection bias, and reliance on self-reported single-item data on sleep duration. Additionally, the sample potentially underrepresented older adults, individuals without sufficient internet access, and those with a lower socioeconomic status.DISCLOSURESFunding information for the study was not provided. Disclosure information for the study investigators is available in the original study publication.This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.