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Sleep and Migraine Interactions in Episodic and Chronic Migraine: A Hospital-Based Cross-Sectional Study

Mathur S, Seshagiri DV, Mythirayee S, Mailankody P, Raja P, Ahmed S, Nair BVS, Kamble N et al.

Annals of Indian Academy of Neurology, 2026

253 participants

Abstract

Background and objectives: Migraine and sleep disturbances frequently coexist. The study aimed at characterizing sleep disturbances and their association with migraine characteristics.

Methods: In this cross-sectional study, 253 patients with migraine [patients with episodic migraine (pEM) = 103 and patients with chronic migraine (pCM) = 150] were assessed. Migraine-related disability was measured using the Migraine Disability Assessment (MIDAS). Sleep-related parameters were measured using the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), and the Berlin Questionnaire. Depression and anxiety were assessed using the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7).

Results: Poor sleep quality was found in 18.4% of pEM and 58.7% of pCM. Headache and sleep disturbances frequently coexisted, with bidirectional triggering in some patients and independent coexistence in others. Sleep health domains (ISI and PSQI subscales) were significantly affected in pCM than in pEM. Excessive sleep-triggered migraine attacks were associated with poorer sleep than inadequate sleep-triggered attacks. On multivariable analysis, a higher MIDAS score, increasing age, and constipation as a prodrome for migraine attacks were each independently associated with poor sleep. In sensitivity analysis, daytime sleepiness (ESS) was significantly associated with migraine disability (MIDAS) (ρ ≈ 0.514, P < 0.001) and…

How strong is the evidence?

Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 253 participants or records.

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