Evidence Hub

Association between obstructive sleep apnea and migraine: A United States population-based cohort study

T. T. Chen, T. Y. Hsieh, Yu-Hsun Wang, Renin Chang, Yao-Min Hung, James Cheng-Chung Wei

Headache, 2025

196,864 participants · 6 citations

Abstract

OBJECTIVE: To determine the association between obstructive sleep apnea (OSA) and the incidence of migraine using a large population-based dataset, as well as to identify the at-risk target groups.

BACKGROUND: Epidemiological and biochemical studies have provided evidence for the close connection between sleep disorders and migraine. Understanding the connections between OSA and migraine, as well as their shared risk factors, may provide new perspectives on the pathophysiology of both OSA and migraine and novel approaches to managing and treating these conditions.

METHODS: This retrospective cohort study used data from the TriNetX network from 2010 to 2021. We compared 196,864 adult participants with OSA to a group of 196,864 participants who had never been diagnosed with OSA (1:1 propensity score-matching for age, sex, race, comorbidities, and body mass index [BMI] categories) in relation to the risk of incident migraine. We performed subgroup analyses based on age (18-39, 40-59, ≥60 years), sex (female, male), race (White, Black or African American, Asian), BMI categories (<18.5, 18.5-24.9, 25-29.9, ≥30 kg/m2), and the presence of hypoxemia (yes, no). Sensitivity analyses were performed to validate our findings.

RESULTS: During the follow-up period, 12,613 (6.4%) and 6356 participants (3.2%) developed migraine in the OSA and non-OSA cohorts, respectively. Patients with OSA were found to have a 1.85-fold risk (hazard ratio [HR] 1.85; 95% confidence interval [CI] 1.79-1.90)…

How strong is the evidence?

Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 196,864 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

Read the paper

Related studies

Go deeper in Evidence Hub

Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.

Open this study Sign up free